Job Description
Job Description
Job Description
Location: Remote (Work from Home)
Employment Type: Part-Time or Full-Time (Flexible Schedule)
Pay: Up to $25/hr based on experience
Benefits: Available for full-time positions after transition
Reports To: Team Supervisor
Job Summary The Quality Improvement Specialist (QIS) serves as a key member of a multidisciplinary team dedicated to improving the quality of healthcare for Medicaid beneficiaries enrolled in managed care plans (MCPs). This role provides both quality assurance and administrative support for external quality review activities across four programs within the State Department of Health/Human Services (Office of Medicaid and Medicare). The ideal candidate will have experience in healthcare quality improvement, strong attention to detail, and excellent communication skills.
Key Responsibilities
Quality Improvement & Assurance
- Validation of MCP Performance Improvement Projects: Ensure project design is methodologically sound, barrier analysis and interventions are appropriate, and results are valid, reliable, and interpreted correctly.
- Compliance Reviews: Participate in MCP compliance reviews, including preparation of crosswalks, tools, worksheets, and correspondence; review documents and files; conduct virtual and onsite interviews; and prepare reports.
- Project Management: Assist with project planning, execution, and documentation to ensure goals are met on time.
- Report Writing: Prepare and maintain comprehensive project documentation, reports, and presentations.
- Data Quality Assurance: Perform quality assurance checks on reports (proofreading, comparing data in tables to source documents), and verify data accuracy and consistency.
Administrative & Support
- Scheduling and Coordination: Schedule and manage status calls (approximately 10 per month).
- Meeting Support: Take minutes during status calls, maintain and update meeting minutes format, and manage the edit process (draft by Thursday, finalized by Tuesday).
- Client Management: Administer and maintain a contact database for client management.
- Team Collaboration
Qualifications
- Education:
- Bachelor’s degree or similar experience in nursing, public administration, public policy, public health, or a related field required.
- Experience:
- Minimum of two (2) years of related healthcare quality improvement work experience.
- Previous experience in quality assessment/improvement and report writing preferred.
- Licensed RN, LPN, or MSW preferred, or extensive quality improvement experience.
- Required Skills:
- Strong knowledge of quality measurement and improvement principles.
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint), and Microsoft Planner.
- Experience with ambulatory EHR software is a plus.
- Excellent interpersonal, communication (written and verbal), and presentation skills.
- Ability to work independently and as part of a team with minimal supervision.
- Strong attention to detail, especially for quality assurance tasks.
- Flexibility to adapt to changing department needs and working hours.
- Ability to manage deliverables independently and meet deadlines.
- Willingness to travel to managed care plans and provider sites as required.
Additional Information
Physical Requirements:
- Prolonged Computer Use :
Must be able to sit at a desk and use a computer for extended periods of time (6–8 hours/day) with frequent use of hands/fingers for typing and data entry. - Repetitive Motion :
Requires repetitive motion of wrists, hands, and fingers for tasks such as typing, data review, and report editing. - Hearing and Speaking :
Must be able to clearly hear and communicate verbally in English via phone, video conferencing platforms (e.g., Microsoft Teams), and during virtual or in-person team meetings.
- Mobility :
Minimal physical exertion is required. However, candidate must be able to: - Travel occasionally (if needed) for in-person meetings or onsite reviews, which may involve walking, standing, or light lifting (up to 15 lbs.).
- Move around a home office or temporary field location to gather or review physical materials, when applicable.
Training:
- Training will be provided for specific processes and requirements.
Schedule:
- Flexible schedule available; position may start as part-time with potential to transition to full-time.
Work Environment:
- Remote work environment; must have reliable internet and a suitable workspace.
This position is open to both part-time and full-time candidates, with a flexible schedule to accommodate the right individual.
1 Alpha Consulting LLC is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability, or any other characteristic protected by applicable law. If you need assistance or an accommodation due to a disability, please contact Human Resources at Human- [email protected].
Job Tags
Full time, Temporary work, Part time, Work experience placement, Remote job, Home office, Flexible hours,