This job was posted by https://idahoworks.gov : For more information,
please see: https://idahoworks.gov/jobs/2354278 QUALITY CONSULTANT
(HEALTHCARE)
Work from home (telecommute) within **Oregon, Washington, Idaho or
Utah
Build a career with purpose. Join our
Cause
to create a person-focused and economically sustainable health care
system.
Who We Are Looking For:**
Every day, Cambia\'s Payment Integrity - Clinical Quality Data Team is
living our mission to make health care easier and lives better. The
Quality Consultant develops and implements quality improvement programs
related to clinical quality measurement and outcomes and assists in
resolving deficiencies that impact plan compliance to regulatory
accreditation standards and/or quality measurement. Ensures activities
meet regulatory requirements of the state or product and reflects
Cambia\'s quality strategies, approaches and work plans. - all in
service of making our members\' health journeys easier.
**If you\'re a motivated and experienced Healthcare Quality Data
Professional looking to make a difference in the healthcare industry,
apply for this exciting opportunity today!
Preferred Key Experience:**
Medical Record Review (Extraction)
HEDIS (Preferred not required)
EMR experience preferred
Clinical background (RN or Coding)
What You Bring to Cambia:
Qualifications and Certifications:
Quality Consultant would have a bachelor\'s degree in business
administration or related field
6 years of progressive experience in health care administration,
quality, project management or project support
Or equivalent combination of education and experience.
Skills and Attributes (Not limited to):
Knowledge of quality improvement processes and performance
measurement and ability to develop and accomplish clinical quality
measurement and/or program activities.
Demonstrated ability to identify problems, develop solutions and
implement a chosen course of action.
Leadership skills with the ability to direct activities of others
both individually and within a project team .
Ability to organize, plan, prioritize and develop multiple projects
within time constraints.
Strong knowledge and understanding of data integrity/validity
standards and significance.
Ability to perform sound basic quantitative and qualitative analyses
and interpretation.
Knowledge of the healthcare industry, preferably in the managed care
market.
Excellent verbal and written communication skills including ability
to communicate effectively across multiple areas and levels.
Participation in successful NCQA/URAC accreditation process, AND/OR
full HEDIS production reporting and continuous process improvement
experience preferred.
What You Will Do at Cambia (Not limited to):
Develops and maintains required/applicable quality program
documents, including a standardized quality management plan and
program to ensure compliance with external regulatory and
accreditation and/or performance measurement requirements.
Serves as a point of contact, coordinating and collaborating with
accreditation entities and business partners to ensure compliance
with accreditation and/or performance measurement requirements.
Prepares enterprise for accreditation and/or performance measurement
submissions and reviews.
Serves as the subject matter expert for applicable accreditation
standards/measurement requirements. Makes recommendations to
business unit partners for improvements or remediation to
accreditation/reporting compliance/improvement programs.
Monitors exposure to accreditation/measurement risks and identifies
opportunities to manage and mitigate those risks.
Compiles information related to quality improvement and
accreditation monitoring activities for internal use and external
audits and maintains relevant records.
Assists with the development and maintenance of required quality
program documents. Responsible for reporting activities to the
quality committee and management.
The expected hiring range for the Quality Consultant is \$80k-\$90k,
depending on skills, experience, education, and training; relevant
licensure / certifications; performance history; and work location. The
bonus target for this position is 10%. The current full salary range for
this position is \$78k Low/ \$98k MRP / \$128k High
About Cambia
Working at Cambia means being part of a purpose-driven, award-winning
culture built on trust and innovation anchored in our 100+ year history.
Our caring and supportive colleagues are some of the best and brightest
in the industry, innovating together toward sustainable, person-focused
health care. Whether we\'re helping members, lending a hand to a
colleague or volunteering in our communities, our compassion, empathy
and team spirit always shine through.
Why Join
