Quality Improvement Specialist - Remote (Or The Portland Metro Area Preferred)

Job Title
Quality Improvement Specialist - Remote (OR the Portland Metro Area preferred)
Duration
Open Until Filled
Work From Home
Yes
Description
Let’s do great things, togetherFounded in Oregon in 1955, ODS, now Moda, is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.Our Dental Services department is looking for a Quality Improvement Specialist to join their team. The Quality Improvement Specialist serves as the ODS Community Dental contact to Coordinated Care Organizations (CCO) for quality improvement initiatives. Interacts with internal and external partners to define quality program requirements, develop project work plans, execute project tasks and deliverables, document and report project status, and evaluate the effectiveness of quality programs.This is a Full-Time Remote PST position. This position is open to candidates living in Oregon. Candidates living in the Portland Metro Area are preferred. Follow the link below and complete an application for this position.
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Benefits

• 401K- Matching
• PTO and Company Paid Holidays
• Medical, Dental, Vision, Pharmacy, Life, & Disability
• FSA
• Employee Assistance Program

Schedule

• PST

Requirements

• Ability to be self-sufficient, innovative, work independently and as a team in a fast paced, multi-faceted project.
• Strong interpersonal and communication skills (both oral and written) with a customer service emphasis.
• Experience in project plan development and project management.
• Knowledge and experience with Oregon Administrative Rules to ensure compliance with contractual requirements.
• Strong analytical, problem solving, decision making, organizational, and detail orientation skills.
• In depth knowledge of operations of CCO dental contracts or dental Medicaid.
• 3 – 5 years’ experience in healthcare insurance industry.
• Ability to work well under pressure, including frequent interruptions and shifting levels of priority.
• College degree or equivalent work experience in the healthcare industry preferred.
• Strong project related software skills including Microsoft office suite, including Excel and VISIO.

Primary Functions

• Document and report quality and performance initiatives developed by CCOs to appropriate internal stakeholders.
• Performs additional duties as assigned
• Perform quality assurance validations of project deliverables to ensure they meet the overall CCO standards and needs.
• Collect and analyze data reporting for various quality improvement initiatives including language access, access to care, etc.
• Ensure compliance with applicable Oregon Health Authority and CCO-contracted deliverables and quality improvement standards and initiatives.
• Prepare for audits and reviews by external review organizations for OHA and CCOs.
• Seek out and participate in professional growth and development activities.
• Oversee the collection and analysis of data and prepare pertinent documentation and reporting for quality improvement committees, and CCO quality and operations meetings.
• Active member of the dental metrics committee.
• Develop and update quality improvement policies and procedures including UPMs.
• Represent ODS Community Dental at CCO quality meetings and ensure the appropriate follow-up to meeting assignments.
• Work with other Moda departments to develop and vet program materials for CCO quality incentives and performance programs established by the CCOs.
• Supports and contributes to the work of the Dental Quality Improvement Committee.

Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our [email protected] email.
Pay Range
¤59,475.00
Annually to ¤68,256.21
Annually