Quality, Innovation, and Experience: Setting Us Apart
Healthcare Quality Management Specialist
Location
United States
Posted
9 days ago
Salary
0
Seniority
Senior
Job Description
Healthcare Quality Management Specialist
Medical Review Institute of America, LLC
• partner with key members of leadership for the design and implementation of Quality Management procedures • ongoing improvement efforts, and other team projects with the aim of achieving organizational, accreditation, and regulatory requirements • Review and analyze current processes related to the application and implementation of policies, procedures, and practices • provide leadership with recommendations for updates to comply with the current regulatory and accreditation requirements • Identify gaps in efficient process workflow and suggests steps for quality process improvement • Measure process performance using valid and accurate methods; analyze trends, variation, and process stability to determine if defined performance metrics are met and identify areas of risk • lead and support structured quality improvement initiatives (e.g. DMAIC or equivalent) • Manage and lead Quality Improvement Projects (QIPs) • Manage and ensure execution of CAPAs, including documented root cause analysis, defined success metrics, implementation tracking, and post-implementation validation demonstrating sustained improvement in coordination with the Clinical Quality, Compliance, and Operations leaders • Serve as liaison between clients and MRIoA’s quality management department as needed • Assist leadership in establishing and reporting quality metrics
Job Requirements
- Minimum of 5 years’ experience in a quality management role
- Demonstrated experience applying structured quality improvement methodologies (e.g., Lean, Six Sigma, DMAIC) required
- Working knowledge of managed care and utilization review accreditation standards, including URAC and NCQA, and multi-state regulatory requirements
- Six Sigma Green Belt or equivalent certification preferred
- Exceptional customer service skills
- Exceptional analytical and critical thinking skills
- Excellent oral and written communication skills and interpersonal skills
- Exceptional orientation to detail
- Excellent organizational skills
- Ability to work under pressure and meet deadlines while managing multiple high priorities and supporting a flexible schedule
- Knowledge and understanding of the Company’s clients, products, departments, and workflows
- Personal computer literacy and competency in use of Microsoft Word, Microsoft Excel (intermediate skill), Power Point and PowerBI
- Ability to maintain a high level of objectivity and confidentiality
- Experience in quality improvement activities within a healthcare, health insurance and/or managed care organization preferred
- Experience in supplying small group and individual training preferred
- Experience in research beneficial and preferred
Benefits
- healthcare, vision and dental insurance
- a generous 401k match
- paid vacation
- personal time
- holidays
- Growth and training opportunities
- A team atmosphere with fun events and prizes scheduled throughout the year
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