Job #: 1381
Title: Quality Management Operations
Momentum is looking for a QM Specialist.
The primary function of the QM Operations Specialist is to support and coordinate Quality Management Operations activities. The QM Operations Specialist should be able to work independently, using good judgement and seeking assistance when necessary. This position provides administrative support for Quality Management Operations functions and initiatives as well as operational project coordination for Quality Review activities. The position will also be responsible for duties tied to the development of new programs and initiatives as assigned by the Director of QM Operations.
Administrative Support for Quality Management Operations
· Responsible for QM Operations staff and workgroup meeting administration:
· Drafts, maintains and distributes pertinent documents i.e. agenda, meeting minutes, work plans, etc.
· Calendar events including organizing and maintaining meetings. As well as printing meeting materials.
· Under the direction of the QM Operations Director, responsible for drafting and/or collecting QM Operations documents, i.e. project SOPs, presentations, memos, flowcharts, templates, etc.
· Updates and distributes the QM work plan; includes follow up with all QM Department Directors and working with all departments to complete Program Evaluation documents.
· Coordination and tracking of up to date QM Policies and Procedures, includes notifying policy owner with enough lead time when a policy update must be completed.
· Maintains up-to-date and comprehensive electronic and paper filing systems. Responsible for coordinating off-site HEDIS and QARR record retention.
· Responsible for set up and maintenance of QM SharePoint folder/site. May assist in the development of root cause analysis, interventions and action plans, project planning, tracking and outcome summary reports.
Operational Project Coordination for Quality Review Activities
· Assists in conducting telephonic outreach to target populations; including evaluation and education when necessary.
· Assists in the maintenance and first-line support of QM Operations databases; prepares spreadsheets; reviews data refreshes to ensure accuracy; maintains reports summarizing the activities for QM Operations.
· Responsible for fulfillment of project initiatives, including incentive management as needed.
· Supports the daily administration of the HEDIS Medical Record Review project operational component.
· Enter patient’s records into centralized databases for tracking & QA of records. Supports the development and monitoring of supplemental databases used for HEDIS reporting.
· Conducts research via Web searches, review of newsletters and identification of educational material based on quality review findings and to support outreach initiatives.
· Assists with the review and update of Health Plan website and newsletters for Quality Review initiatives.
· Other duties as assigned by Director of QM Operations.
· Bachelor’s Degree preferred.
· Minimum of two years relevant work experience in a managed care or health plan setting.
· Knowledge of HEDIS and QARR specifications
· Knowledge of QM principles such as PDSA or DMAIC preferred
· Must have strong working knowledge of Microsoft Office applications including Word, Excel, PowerPoint, Visio and Access.
· Ability to travel within the service area when needed.
· Integrity and Trust
· Customer Focus
· Functional/Technical skills
· Written/Oral Communication
· Strong written and verbal presentation as well as data analysis skills required to ensure ability to present data in a clear and concise manner.
· Ability to resolve simple issues independently and provide support and implement resolution of complex issues.
· Ability to work independently, be motivated and possess excellent organizational skills and attention to detail.
· A familiarity with basic QI process improvement methodology.
· Ability to quickly learn and then teach new systems and technology.
· Ability to prioritize to ensure reporting timeframes and deadlines are met.