Quality Improvement Specialist

Job Description

Job Description

In the Quality Improvement Specialist (QIS) role, you will provide clinical support for External Quality Review activities, including validation of Performance Improvement Projects (PIPs), compliance reviews, and focused studies and must have the ability to work independently with minimal supervision. The Quality Improvement Specialist will communicate with State agencies, MCP quality and clinical staff, and other provider staff, as necessary. This individual may travel to health plans/physician practices/other providers in states for which IPRO serves as an External Quality Review Organization (EQRO). The Clinical QI Specialist will have a focus on Performance Improvement Projects (PIPs). Duties to include but not limited to:

• Assisting in the development of tools and participating in review and validation of Performance Improvement Projects.
• Participation in training and Internal Quality Control (IQC).
• Providing information/data for the preparation of summary reports of review activities.
• Validating MCP-reported data (e.g. HEDIS, QARR, encounter data) against medical records.
• Participating in the review of documents and conducting interviews for MCP compliance and readiness reviews. Reviews may be conducted virtually or onsite.
• Mentoring peers in all responsibilities as appropriate.
• Accepting new responsibilities in response to changing department needs.

This position is office based at our Jericho, NY, Albany, NY or Beachwood, OH office.

QUALIFICATIONS:

• Exceptional communication (written and verbal) skills.
• Advanced proficiency in PC-based computer software, especially Microsoft Office Suite products.
• Proven ability to work independently with minimal supervision and as part of a team.
• Strong ability to relate effectively with medical, technical, analytic and administrative personnel.
• Willingness and ability to travel to on-site review assignments, both local and out of area/overnight travel.
• Flexibility to work varied days and hours when necessary.

EDUCATION & EXPERIENCE:

• Bachelor’s degree in nursing, public administration, public policy, public health, or a related field, required.
• Two (2) years of related health care quality improvement experience, required.
• Previous experience with PIP review and validation required.
• Master’s degree in public health, quality improvement science, health informatics, or related field preferred. Relevant work experience in the field may substitute.
• Licensed RN, LPN, or LMSW, LCSW, LISW, LSW preferred, OR extensive quality improvement experience in an MCP environment.
• Previous report writing experience, preferred.

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The annualized salary range for this position is $80,000.00 – $110,000.00. Actual salary range and /or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget.

The salary range and/or hourly rate listed does not include other forms of compensation or benefits.

IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status, or any other category protected under applicable law.