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QA Project Manager
Ref No.: 17-24150
Location: Downers Grove, Illinois
JOB DESCRIPTION
  • The Quality Management (QM) Manager is a key quality leader who is responsible for driving HEDIS results at a large health Plan, ensuring that the Plan meets its P4P and HEDIS standards required for NCQA accreditation.
  • The position will also be responsible for working with inter-disciplinary teams, the State, and CMS to drive quality measures at the Plan.
  • The QM Manager must have managed care and health plan experience in Medicaid, Medicare or Commercial.
  • The Manager will work closely with cross-departmental leaders and staff to drive HEDIS performance, analyses of HEDIS data, and CAHPS results, as well as preventive and well care intervention projects to close gaps in care.
  • This role works with the Plan’s Compliance Department on audits, including but not limited to HSAG, CMS, and internal audits, as well as meeting State and CMS quality improvement requirements.
  • Superb professional verbal and written skills, with the ability to communicate clearly and concisely to vertical and horizontal audiences.
  • The ability to manage competing priorities is critical.
QUALIFICATION
  
  • Education Bachelor's degree or equivalent experience Licenses and Certifications HEDIS Auditor
  • National Association Healthcare Quality
  • NAHQ Lean Six Sigma Functional Experience Functional
  • Quality Management
  • Quality Management/4-6 Years Functional
  • Leadership - Lead a business in different geographies or multiple markets
  • 4-6 Years Functional - Nursing - / Functional - Management - Management - Quality/4-6 Years Functional - Leadership - Lead a major change effortùculture change/4-6 Years Technology Experience Technical - Desktop Tools - TE Microsoft Excel/7-10 Years/ Technical - Desktop Tools - Microsoft Word/4-6 Years/ Technical - Desktop Tools - Microsoft PowerPoint/4-6 Years/ Technical - Desktop Tools - Microsoft Visio/1-3 Years/