About the role

Quality Initiatives Specialist at MercyCare Insurance responsible for leading quality improvement initiatives for health plan members. Analyzing clinical quality measures to ensure compliance and enhance patient care.

Responsibilities

Acts as a lead specialist to provide project, program and /or initiative-related direction and guidance for other specialists within the department and/or collaboratively with other departments.
Assists in monitoring and analyzing outcomes to ensure goals, objectives, outcomes, accreditation and regulatory requirements are met.
Program and support Microsoft Access databases to manage targeted disease populations and provide efficiencies in work processes.
Design and implement strategies for outcomes improvement based on membership population characteristics and business functions requirements.
Participate in the implementation of Continuous Quality Improvement activities by contributing front line knowledge of projects and observations.
Develop optimal alternative solutions based on feedback and environmental analysis.
Implement process improvement using innovative thinking, root-cause-analysis, process mapping, and charting techniques.
Complete Quality Initiative projects according to specifications and requirements.
Provide follow up and education of providers and clinic staff on measures and project objectives.

Bachelor's degree from a four-year college or university in related field or at least 5 years of related experience.
Three years of experience in managed care or health care delivery systems.
Experience with EPIC applications (Tapestry and Healthy Planets)
Experience with the following Continuous Quality Improvement methodologies required: Qualitative and quantitative data collection, management, analysis, and reporting.
Certification and Licensure Certified Professional in Health Quality (CPHQ) or Registered Health Information Technician (RHIT) preferred.

Comprehensive Benefits Package: Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options.
Competitive Compensation: Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs.
Paid Time Off: Mercyhealth offers a generous paid time off plan, which increases with milestone anniversaries, to allow employees the opportunity for a great work-life balance.
Career Advancement: Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth.
Employee Wellbeing: Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey.
Additional Benefits: Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning.