Quality Assurance Specialist

1 week ago


Cleveland, Ohio, United States Care Alliance Full time
Job Summary

The Quality Assurance Specialist plays a crucial role in ensuring the highest standards of quality care at Care Alliance Health Center. This position is responsible for coordinating quality initiatives, focusing on provider credentialing, patient safety, patient experience, and quality improvement measures.

Key Responsibilities
  • Utilize various databases, including EPIC, Azara, and UDS, to identify and formulate data related to patient needs and clinical programs.
  • Manage all aspects of credentialing, re-credentialing, and contract enrollment for providers, ensuring timely renewal of licenses and certifications.
  • Manage patient data and generate reports for analysis to identify quality-of-care gaps and opportunities.
  • Collaborate with the QA Director to identify and report outlying metrics to review with the leadership team.
  • Review payor program metrics and formulate data required to meet CAHC quality initiatives, participating in monitoring improvement initiatives.
  • Monitor payor care management program targets and ensure timely progress through monthly monitoring and reporting.
  • Work collaboratively with the Director of Quality and Risk Management to implement quality initiatives, including population health initiatives.
  • Maintain a quality dashboard for tracking and reporting purposes, creating reports and metrics data for all CAHC departments.
Requirements
  • Bachelor's degree in Public Health, Epidemiology, Nursing, or a related field, with a combination of education and experience considered in lieu of formal credentials.
  • Minimum 3 years of experience developing and implementing healthcare quality initiatives and data management.
  • Minimum of 3 years of experience generating quality reports, analyzing data, and reviewing clinical workflows.
  • Proficiency in managing insurance payor programs, data abstraction, and following metric trends.
  • Strong attention to detail and ability to prioritize and multitask.


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