Overview

Location: Mockingbird Towers 4th FLRPrimary PurposeResponsible for managing Performance Improvement Projects from inception to completion, ensuring our healthcare services consistently meet the highest standards of quality and efficiency. The role will analyze current practices, identify areas for improvement, and implement strategies to enhance member care, member outcomes and operational efficiency.Minimum SpecificationsEducationBachelor's degree in business administration or related discipline is required.Bachelor's degree in the healthcare field preferred.ExperienceMinimum of 3-5 years of experience in healthcare quality improvement is required.Experience with Texas Medicaid, Medicaid, or managed care quality improvement strongly preferred.Equivalent Education and/or ExperienceMay have an equivalent combination of education and/or experience in lieu of specific education and/or experience.Certification/Registration/LicensureCertification in Six Sigma, Lean, or other quality improvement methodologies preferred.Skills or Special AbilitiesExcellent verbal and written communication skills including the ability to communicate effectively and professionally across disciplines. Ability to communicate complex information in understandable terms.Strong interpersonal and conflict resolution skills with the ability to establish and maintain effective working relationships across and beyond the organization.Excellent analytical and problem-solving skills.Strong time management and organizational skills with the ability to manage multiple demands and respond to rapidly changing priorities.Ability to write clearly and succinctly with a high level of attention to detail.• Proficient computer and Microsoft Office skills. Ability to learn new software programs.Knowledge of Texas Medicaid, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual.Proficiency in data analysis software and tools.Clinical experience is a plusStrong project management skills.Ability to work independently and take initiative.Responsibilities Quality Develop and implement quality improvement initiatives.Use quality improvement tools and techniques such as Six Sigma, Lean, and PDSA cycles.Lead end-to-end management of PIPs, from conception through planning, execution, monitoring, and closing, ensuring all milestones are met and documented.Ensure member and staff feedback is incorporated into quality improvement efforts.Integrate health literacy principles into all communication including Members and Providers.Support strategies that meet clinical, quality and network improvement goals.Promote the use of Health Information Technology to support and monitor the effectiveness of health and social interventions and make data-driven recommendations as needed.For staff in clinical roles, foster collaborative relationships with members and/or providers to promote and support evidence-based practices and care coordination.Prepares reports for HHSC according to HHSC requirements and timelinesCoordinate with external agencies when required by the projectTracks and monitors all interventions implemented and evaluates the impact of each intervention utilizing data driven methodologies,Makes adjustments to interventions as required per performance indicatorsSupports quality leaders develop quality plans and ensure integration of quality into overall business processes.Develops performance improvement plans and oversees quality improvement activities to improve the quality of care for members.Develop plans to improve HEDIS scores and other quality metrics prepare and present them to management and Providers. Performance Analysis Analyze current healthcare practices and identify areas for improvement, and present findings and recommendations to senior management and other stakeholders.Monitor and evaluate the effectiveness of quality improvement initiatives.Collect and analyze data to measure performance and outco