Quality Metrics Specialist-Health Plan
Responsibilities
- Monitoring, tracking, trending, analyzing, and reporting all data, performance measures, and other required information requested by various accrediting or regulatory bodies.
- Monitoring data and action plans related to HEDIS or other projects/programs overseen by the Quality Improvement department.
- Cross-functional coordination internally and externally to support HEDIS data collection, validation, and other assigned projects.
- Supporting the department with the collection and analysis of related data/information and development of strategies/processes to improve performance outcomes.
Requirements
- High School Diploma or equivalent.
- Bachelor's degree (B.S.) from four-year college or university preferred.
- Health Plan Claims or Clinical experience required.
- Requires moderate to expert experience with computer programs, including Microsoft Office programs (Word, Excel, and PowerPoint).
Qualifications
- Licensed Vocational Nurse or Registered Nurse.
Skills
- Project Management
- Quality Improvement
- Data Analysis
- Microsoft Office Suite
Benefits
(Not specified)
Pay
(Not specified)
Schedule
(Not specified)
About the Role
The Quality Metrics Specialist is responsible for implementing processes in the Quality Improvement department regarding project management, and quality improvement within a managed care organization. Responsibilities include monitoring, tracking, trending, analyzing, and reporting all data, performance measures, and other required information requested by the Health and Human Services Commission (HHSC), Centers for Medicare and Medicaid Services (CMS), Texas Department of Insurance (TDI), National Committee for Quality Assurance (NCQA) or any other accrediting or regulatory bodies. Monitors data and action plans as they relate to HEDIS or other projects/programs overseen by the Quality Improvement department. Coordinates cross-functional efforts internally and externally to support HEDIS data collection, validation and other assigned projects. Supports the department with the collection and analysis of related data/information and in the development of strategies/processes to improve performance outcomes.
Skills
- Project Management
- Quality Improvement
- Data Analysis
- Microsoft Office Suite
Benefits
(Not specified)
Pay
(Not specified)
Schedule
(Not specified)