Quality Improvement Program Analyst II

2 weeks ago


Cedar Falls, Iowa, United States Iowa Total Care Full time

Transforming Healthcare for Our Members

You could be the catalyst for change for our 28 million members. Iowa Total Care is dedicated to enhancing the health of our communities, one individual at a time. As a diverse, national organization, we offer competitive benefits and a fresh perspective on workplace flexibility.

** This position allows for remote work from anywhere within the state of Iowa, with travel expectations below 20%**

Position Overview: Your role will involve identifying market trends and overseeing the functions of quality enhancement programs related to HEDIS or CAHPS strategies and associated quality improvement initiatives. You will assist stakeholders in identifying their business challenges and recommending solutions that drive value. This includes analyzing stakeholder issues, formulating hypotheses, and testing conclusions to identify appropriate solutions.

  • Conduct evaluations to support HEDIS gap closure or assess member/patient experiences for potential pilot programs and process improvements aimed at achieving sustainable quality performance goals. This assessment encompasses a comprehensive evaluation of measure technical specifications, performance trends, stakeholders, industry literature, organizational initiatives, and relevant policies and procedures.
  • Collaborate with assigned markets to drive ongoing measure performance. Develop resources and tools to support HEDIS initiatives and foster gap closure. Conduct continuous assessments to identify health plan needs, working with cross-functional teams to ensure successful execution.
  • Monitor compliance with state reporting, HHS, and HPMS memos regarding quality ratings. Establish quality check policies and procedures for all member and provider communications to ensure the accuracy of information and alignment with Iowa Total Care's business objectives.
  • Create, maintain, and facilitate training programs for Quality Improvement Health Plan staff as necessary based on assigned responsibilities.
Qualifications: A Bachelor's degree in Nursing, Public Health, Business, or a related field is required; a Master's degree is preferred. A minimum of 4 years of clinical experience, along with managed care member/patient or health insurance experience, is essential; 2+ years of quality experience, provider/market partnership, or CAHPS experience is preferred.

Licensure/Certification: Preferred certifications include Registered Nurse (RN), Licensed Practical Nurse, Licensed Vocational Nurse, or Licensed Clinical Social Worker (LCSW); CPHQ certification is also preferred.

Iowa Total Care offers a comprehensive benefits package that includes competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field, or office work schedules. Actual compensation will be adjusted based on individual skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Iowa Total Care is an equal opportunity employer committed to diversity and values the unique perspectives that each individual brings. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable law.



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