Quality Management Performance Evaluation Specialist

5 days ago


Philadelphia, Pennsylvania, United States Community Behavioral Health. Full time
Job Title:

Quality Management Performance Evaluation Specialist - Behavioral Health Expert

About the Position:

Community Behavioral Health (CBH) is seeking a highly skilled Quality Management Performance Evaluation Specialist to join our team. In this role, you will be responsible for planning, designing, implementing, conducting, and reporting performance evaluation activities.

Key Responsibilities:
  • Collaborate with the HEDIS vendor to report HEDIS measure performance data.
  • Create Clinical Practice Guidelines that assess the quality of service delivery by CBH providers in collaboration with cross-departmental teams.
  • Monitor provider data reporting and provide technical assistance for quality improvement initiatives.
  • Evaluate provider root cause analyses and corrective action plans.
  • Work with the Data Analytics team to synthesize and analyze claims data to support performance evaluation activities.
  • Promote measurement data sharing and evaluation results among internal and external stakeholders.
  • Develop reliable data collection tools, including provider and member surveys, and provider performance evaluation plans.
  • Participate in cross-departmental work groups and conduct Plan-Do-Study-Act (PDSA) Cycles with providers as needed.
Requirements:
  • Masters degree in behavioral health, healthcare, or social sciences with experience in quantitative and qualitative research methods, tool design, and validation.
  • CPHQ Certification preferred or willingness to obtain within one year of employment.
  • Minimum three years post-graduate work experience.
What We Offer:

We offer a competitive salary range of $59,600-$67,000 per year, along with a comprehensive benefits package that includes family planning, fertility, adoption benefits, 403B retirement plan, PTO days/sick days, wellness program, employee assistance program, health, dental, vision insurance, medical, prescription drug insurance, tuition reimbursement, commuter benefits, and flexible spending.

This position requires the ability to work collaboratively across all levels of the organization, including officers, directors, managers, peers, and other stakeholders. The successful candidate must reside in Philadelphia and be legally authorized to work in the United States without sponsorship.



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