Research Support - Laboratory/Non-Laboratory, Staff/Administrative
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Department: 480502 - HR UTS/UNC Partnership
Location: Raleigh, NC
Essential Job Duties:
This Quality Management Specialist position will report to the Senior Program Manager, Quality Management. This position is ultimately accountable for the support of the team portfolio—the quality management/assurance/improvement, provider support and accreditation of health care delivered by Primary Care Case Management (PCCM) and Prepaid Health Plans (PHPs) . This position has responsibility to support a set of quality programs and work with vendors who oversee quality assurance, monitoring, support, and improvement of PCCM and PHPs. This position identifies quality trends; establish short-term and long-term quality goals and interventions and supports initiatives to enhance and improve quality of care and health equity for all Medicaid members.
Manage targeted projects relative to Quality Management and Improvement in the Medicaid program including COVID-19 related initiatives Develop action plans and project charters for various Medicaid quality projects. Monitor, track and review Performance Improvement projects Work with various internal stakeholder groups to ensure adequate input into quality processes to establish quality interventions, objectives, and improvements Develop analytic tools and metrics to monitor and assess both clinical and financial performance of programs and vendors. Identify programmatic trends; establish short-term and long-term program objectives; and identify cost effective initiatives to enhance and improve the quality of care and engagement of providers and members
Working knowledge of process improvement, quality management, quality assurance processes, healthcare measures, and data resources Proven ability to propose and implement strategies to address complex systems changes Demonstrated ability to effectively prioritize and organize work, set clear objectives, and break large-scale projects down to milestone deliverables or outcomes Proven experience multi-tasking, meeting deadlines and working independently with limited supervision Excellent verbal and written communication skills are required to effectively interface with staff of DHB, DHHS, and other agencies, legislators, professional associations, researchers, providers/provider organizations and recipients. Highly proficient with Microsoft Word and Excel
Professional in Health Care Quality (CPHQ) is highly desired. Master's degree in social work, nursing, or health care administration highly preferred
Required license or certification:
Position Number: 48RE60
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If you have general questions about the application process, you may contact Human Resources at (919) 515-2135 or firstname.lastname@example.org. Individuals with disabilities requiring disability-related accommodations in the application and interview process, please call 919-515-3148.
Final candidates are subject to criminal & sex offender background checks. Some vacancies also require credit or motor vehicle checks. If highest degree is from an institution outside of the U.S., final candidates are required to have their degree equivalency verified at www.wes.org or equivalent service. Degree(s) must be obtained prior to start date in order to meet qualifications and receive credit.
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