Job Description:
• participate in performance and quality improvement projects by implementing member and provider targeted interventions.
• contribute to multidisciplinary committees required by NCQA and the State Contract.
• conduct member outreach calls and medical record audits for provider compliance.
• perform provider outreach to close care gaps and audit records to identify improvement opportunities.
• complete and update reports, including State Reports and Kentucky Medicaid Quality Improvement Committee reports.
Requirements:
• 3+ years of previous experience working with member outreach on quality and performance improvement activities.
• 2+ years previous experience in healthcare quality improvement/quality operations.
• Knowledge of HEDIS/CMS/Quality.
• Experience with healthcare quality measures (example HEDIS, CAHPS).
• Comprehensive knowledge of Microsoft Office Word, PowerPoint, intermediate Excel experience (pivot tables/filtering, charts, formulas).
Benefits:
• paid time off
• 401(k) retirement savings plan
• employee assistance program
• business travel and accident
Apply Now
Apply Now