- Develops Network curriculum, provider manuals, guidelines, and onboarding process & documentation.
- Overall management of standardize documentation and workflows.
- Promote and perform continuous quality improvement monitoring.
- Compiles data for trend analysis and reporting so quality action plans can be developed and implemented.
- Oversees the Quality Action Plans and reports back to leadership.
- Facilitates meetings as required to meet targets related to department and company goals.
- Continuous mindset toward efficiency and process improvement – how to apply technology and processes to improve delivery and efficiency from both the Provider Group and internal perspective.
- Responsible for coordinating and facilitating meetings with performance advocates
- Review policies, procedures and workflows, recommending revisions when necessary to comply with regulatory and accreditation standards (HIPAA, DOL/ERISA, UM & CM URAC, NCQA, etc.), and facilitating completion and implementation of revisions. Monitors that staff comply with the established written policies and procedures.
- Participate in accreditation initiatives and assist with completion of activities.
- Assist in developing and updating URAC, Departments of Insurance and NCQA compliance materials with documentation to demonstrate compliance with regulations/standards.
- Assist in completion and submission of accreditation applications.
- Oversees orientation and training for new hires.
- Maintains team audits, competencies, and curriculum and test inventories.
- Partners with other departments in planning the training programs, curriculum, and activities.
- Performs other related duties as assigned.
- Associate degree required. College education preferred.
- Minimum of 2 years’ experience in healthcare
- Working knowledge of Quality Improvement principles and incorporating them into daily functions.
- Proficiency in computer and software programs (e.g. Microsoft Word, Excel).
- Effectiveness in communication style (written and verbal), with proven ability to positively influence behavior toward a positive outcome.
- Self-motivated with the ability to work independently, as well as within a team environment.
- Proficient in data analysis, error discovery and resolution.
- Ability to adapt and quickly learn electronic programs utilized for research.
- Positive, service-oriented attitude. High level of integrity.
- Ability to multi-task and work closely with all associated in data capture and analysis.
Healthcare trailblazer. Top 100 workplace. Fastest growing private company. We’ve been called them all. Here’s one that we’re most proud of: We’re a company that lives our purpose of helping communities thrive.
- Our communities deserve more than the increasingly broken healthcare system we have inherited.
- Innovation must connect the healthcare experience to move people the right way on their health journey.
- Healthcare is better when people are known.
- Those who have earned the most trust will produce the most meaningful change.
Every day, our team works to turn those beliefs into actions that are poised to change the way people think about and receive healthcare. Every day, we support people’s health journeys by authentically living our values: Purpose Driven, Relationships Matter, Serve Others First and Inspire Creativity.
Our inclusive and vibrant culture empowers team members strive, perform and have a lot of fun on the way.
If this connects with you, we’re looking for exceptional talent with a growth mindset … people who are ready to make an impact. We look forward to meeting you!
(if you already have a resume on Indeed)