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Quality Assurance Specialist

2 months ago

Cleveland, Ohio, United States Care Alliance Full time
Job Title: Quality Assurance Specialist

At Care Alliance, we are seeking a highly skilled Quality Assurance Specialist to join our team. As a key member of our quality initiatives team, you will play a critical role in ensuring the highest level of quality care for our patients.

Job Summary:

The Quality Assurance Specialist will be responsible for coordinating our quality initiatives, with a focus on provider credentialing, patient safety, patient experience, and quality improvement measures. You will work closely with our Director of Quality and Risk Management to implement strategies that reduce organization risk and enhance patient care.

Key Responsibilities:

  • Utilize EPIC, Azara, UDS, ODM, HRSA, and other databases to identify and formulate data related to patient needs and clinical programs.
  • Manage all aspects of provider credentialing, re-credentialing, and contract enrollment.
  • Manage patient data and generate reports for analysis to identify quality-of-care gaps and opportunities.
  • Work 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.
  • Monitor payor care management program targets and ensure timely reporting.
  • Collaborate 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.

Requirements:

  • Bachelor's degree in Public Health, Epidemiology, Nursing, or a related field.
  • 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.
  • Proficient in managing insurance payor programs.
  • Strong attention to detail and ability to prioritize and multitask.

Why Join Our Team:

Care Alliance is a mission-driven organization dedicated to providing high-quality, comprehensive medical and dental care to those who need it most. As a Quality Assurance Specialist, you will have the opportunity to make a meaningful impact on the lives of our patients and contribute to our organization's mission.