Quality Improvement Specialist (CAHPS)
Location: Orange, California US
Job Number: 1789
Position Title: Quality Improvement Specialist
The Quality Improvement Specialist (CAHPS) is responsible for quality improvement activity within the STAR program, including CAHPS project management, CAHPS process improvement, CAHPS campaign coordination and outcomes measurement.
(May include but are not limited to)
- Possess a deep understanding of the Medicare STARS program and assist with implementation and execution of strategy related to the program.
- Coordinate the planning and execution of quality initiatives and CAHPS campaigns for the Medicare STAR program. This may include material development, mailing campaigns, IVR calling campaigns, case reviews, and other cross-functional initiatives to improve member outcomes.
- Track and report on outcomes and KPI’s for the program to ensure progress is met throughout the various project life cycles.
- Assist in tracking projects and actions using designated operating and project plans.
- Responsible for formulating and executing all processes, requests, workflows or policies as requested by management in an efficient manner, including offering a proactive approach to suggestions and recommendations.
- Responsible for collecting data from various sources.
- Use critical thinking skills to solve a wide array of problems and use a solutions-based approach when presenting issues.
- Implement process improvements to streamline departmental functions.
- Preparation of meeting materials or training documentation as needed.
- Ensure patient privacy is protected by adhering to HIPAA standards, company policies and procedures, and other federal, state, and local requirements.
This position has no supervisory responsibilities.
- Minimum Experience:
- Minimum 2-3 years of quality improvement, Medicare STAR program experience with an emphasis on CAHPS, managed care, or medical group/IPA setting.
- Bachelor’s degree (BA or BS) from four-year college or university in a health-related field (Health Science, Health Administration, or related) required.
- Proficient in Microsoft Office (Outlook, Excel, Word, PowerPoint required. Visio and Access are preferred) and familiar working with large data sets.
- Knowledge of medical terminology and HIPAA.
- Mathematical skills, attention to detail, problem solving and analytical skills are essential.
- Self-starter; able to work independently with minimal supervision.
- Strong communications skills: written, verbal, and interpersonal
- Valid Driver’s License
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
- The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Location City: Orange
Location State: California
Community / Marketing Title: Quality Improvement Specialist (CAHPS)
Who is Alignment Healthcare?
- Socially responsible
- Technologically enabled
- Concierge care
- Servant leadership
We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.
We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.
EEO Employer Verbiage:
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact email@example.com.