This position is responsible for assisting the Clinical Regulatory and QI Department (CRQI) in the management of the Quality Improvement Committee (QIC) and Peer Review Committee (PRC) and (ii) the development, implementation, and improvement of clinical quality assurance and performance improvement functions for the Company. This position helps to ensure that quality improvement initiatives support the delivery of outstanding patient care and maintain compliance with regulatory and auditing standards.
Essential Position Functions
- Provide leadership in developing, implementing, operationalizing and sustaining short and long term plans, goals and objectives for the QIC functions.
- Ensure QIC achieve desired outcomes and meet federal and state regulations.
- Collaborate cross-functionally with Data Analytics and other departments to collect data, analyze and report on program objectives and to address QIC initiatives.
- Provide ongoing data analysis to support oversight of ongoing initiatives.
- Communicate issues or developments identified during quality improvement and quality assurance activities and provide recommendations for improvement.
- Facilitate the development of action plans to address identified opportunities for improvement.
- Develop and implement metrics to measure quality outcomes. Create processes and methods for data collection and reporting systems.
- Lead QIC team and facilitate activities in a timely manner.
- Support Medicaid program quality improvement program requirements.