GENERAL SUMMARY
Supervises the day-to-day quality improvement activities. Responsible for ensuring compliance with State regulations and national accrediting body requirements.
ESSENTIAL RESPONSIBILITIES
- Responsible for compliance with State and Federal quality regulations. Ensures all quality improvement activities are conducted according to regulatory guidelines and principles.
- Assists with the development of new quality improvement activities to improve the quality of care service in the most efficient mannner.
- Ensures the maintenance of accurate documentation for all quality improvement activities, i.e., surveys, audits, peer reviews, etc.
- Ensures all departments including credentialing, provider relations, health services, and customer service collect and report quality improvement information to the Quality Improvement Committee, including the monitoring and evaluation of indicators.
- In conjunction with senior medical management, prepares the agenda and manages the activities of the Quality Improvement Committee.
- Supervises data collection for Healthcare Effectiveness Data and Information Set (HEDIS) measures. Identifies opportunities for improvement based on the HEDIS results.
- Oversees the annual Medical Record Documentation/Preventive Services clinical study.
- Remains current with new developments in the field of quality improvement.
- Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel actions including employment, termination, performance reviews, salary review, and disciplinary actions.
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Bachelor’s degree or equivalent experience. Master’s degree preferred.
- Previous (3-5 years) quality improvement experience required.
- Previous clinical experience or health education experience preferred.
- Previous supervisory experience preferred.
- Certified Professional in Health Quality (CPHQ) preferred.
- Demonstrated organizational, analytical, and problem solving skills.
- Excellent verbal and written communication skills.
- Proficiency in data analysis and presentation; ability to analyze and explain health care quality and cost information.
- Ability to use standard corporate software packages and corporate applications.Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: , , US
Other Locations: Harrisburg-Pennsylvania-United States,
Organization: 23000 - HealthAmerica Pennsylvania Inc
Schedule: Full-time
Job Posting: 2013-02-07 00:00:00.0
Job ID: 1310427