Opportunity for career advancement and growth within the organization
Engaging and impactful role overseeing clinical quality initiatives
Supportive and collaborative work environment
Chance to make a positive impact on member and community health outcomes
Potential for travel, offering diverse experiences and professional networking
What to Expect (Job Responsibilities):
Act as a lead specialist providing direction and guidance for member intervention initiatives
Implement evidence-based member intervention strategies to remove barriers to care
Monitor key member intervention activities, ensuring timely and accurate completion
Write narrative reports interpreting regulatory specifications and documenting program findings
Evaluate project/program activities to identify opportunities for improvement
What is Required (Qualifications):
Bachelor's Degree or equivalent combination of education and work experience
Minimum of 3 years of experience in healthcare, with at least 2 years in health plan member interventions or managed care
Demonstrated solid business writing experience
Operational knowledge and experience with Excel and Visio
Excellent problem-solving skills and adaptability to change
How to Stand Out (Preferred Qualifications):
1 year of experience in Medicare and Medicaid managed care
Experience with data reporting, analysis, and/or interpretation
Certified Professional in Health Quality (CPHQ)
Nursing License (RN may be preferred for specific roles)
Certified HEDIS Compliance Auditor (CHCA)
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.