SPECIALIST - QUALITY MANAGEMENT

Works in conjunction with operational and clinical staff to facilitate Quality Management/Performance Improvement programs. Supports monitoring activities to ensure quality across CenterLight Healthcare and collaborates with performance improvement initiatives to ensure care delivery and services meet the highest standards of care.

Responsibilities

• Utilize quality improvement methodologies (PDSA, Six-Sigma, Lean, or other standardized tools) to assist business owners in driving quality improvement initiatives.
• Use sound clinical judgment to identify deviations in clinical standards of care delivery.
• Serve as liaison between PACE sites, department leaders, medical directors, and Quality.
• Conduct root cause analyses to identify deficiencies and implement evidence-based interventions for Level 2 Incidents.
• Monitor and investigate all potential or identified quality of care incidents; collaborate with appropriate staff to determine impact and next steps.
• Conduct monthly internal monitoring and audits to identify opportunities for performance improvement.
• Participate in site/center preparation and execution of audit readiness by regulatory and accreditation agencies (State, Federal, CMS, NCQA, etc.).
• Collect, summarize, and analyze performance data to identify opportunities for improvement.
• Support, facilitate, and participate in Quality committees and workgroups.
• Investigate and incorporate national best practice interventions to drive improvements.
• Draw conclusions from data analysis to initiate and facilitate performance improvement projects.
• Maintain working knowledge of regulatory requirements related to quality for health plan and care delivery products.
• Identify and escalate urgent quality and operational matters.
• Conduct, analyze, and report results of quality audits.

Requirements

• Bachelor’s degree in Nursing, Public Health, Epidemiology, or other related health field required; Master's Degree preferred.
• 3–5 years of progressively responsible related work experience, including regulatory agency standards and performance improvement initiatives.
• Excellent written and oral communication skills.
• Ability to communicate effectively with people at varying levels of education and within the organization.
• Ability to work effectively in a fast-paced environment.
• Proficiency in Microsoft Office products (Teams, Word, Excel, Outlook, PowerPoint) and data management systems.
• Experience working with clinical and non-clinical departments and influencing buy-in for quality improvement initiatives.

Physical Requirements

• Standing: up to 6 hours a day.
• Sitting/Stationary: sedentary position for up to 6–8 hours a day for consecutive periods.
• Lifting/Push/Pull: up to 50 pounds using OSHA guidelines.
• Bending/Squatting: required to perform essential job functions.
• Stairs/Steps/Walking/Climbing: must safely maneuver stairs and walk to access work areas.
• Agility/Fine Motor Skills: required to operate equipment, devices, and tools.
• Sight/Visual Requirements: must read and accurately document information.
• Audio Hearing and Motor Skills: must listen attentively and speak clearly for effective communication.
• Cognitive Ability: must demonstrate good decision-making, reasoning, and analytical skills.

Pay

$86,400.00 – $105,000.00

Schedule

40 hours per week, Monday–Friday, 8:30 AM – 5:30 PM.