Clinical Quality Improvement Supervisor

6 days ago


Anderson, South Carolina, United States Absolute Total Care Full time
Job Title: Clinical Quality Improvement Supervisor

Join our team of dedicated professionals at Absolute Total Care and take on the challenge of improving healthcare outcomes for our members.

About the Role:

We are seeking a highly skilled Clinical Quality Improvement Supervisor to lead our HEDIS project management efforts. As a key member of our Medical Management/Health Services team, you will be responsible for ensuring the accuracy and reporting of HEDIS data, including investigations, auditing, and improvement opportunities.

Key Responsibilities:
  • Coordinate activities, resources, methods, and procedures to achieve improvement in HEDIS measures with business leaders and cross-functional departments
  • Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines
  • Supervise daily activities of staff to promote quality improvement and efficient methods
  • Assist with comprehensive analysis of HEDIS measures, barriers, and opportunities and present results of improvement efforts and ongoing performance measures
  • Coordinate clinical quality metrics and HEDIS processes and results
  • Coordinate cross-functional processes to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
  • Manage and coordinate HEDIS projects, including assignment of nurses, adherence to plan timelines, and vendor oversight for timeliness and quality
  • Ensure compliance for all quality audits and maintain all data and process controls
Requirements:

We are looking for a candidate with a Bachelor's degree in Business Administration or Health Care Administration or equivalent experience. 3+ years of quality improvement, HEDIS project management, or healthcare-related experience is required. Working knowledge of NCQA and HEDIS programs is a must.

What We Offer:

At Absolute Total Care, we offer a comprehensive benefits package, including 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 pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

We are an equal opportunity employer that is committed to diversity and values the ways in which we are different. 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 other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act



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