At Modis, we use our insight, knowledge and global resources to make exceptional connections every day. With 60 branch offices located strategically throughout North America, we are positioned perfectly to deliver the industry's top talent to each of our clients. Clients choose Modis as their workforce partner to solve staffing challenges that range from locating hard-to-find niche talent to completing quick-fill demands.
Position: Quality Improvement Manager
Salary: $95,000 - $145,000
Location: Camarillo, CA 93010
Modis Burbank is looking for a Quality Improvement Manager for a great client in Ventura County. This position reports to the Director of Quality Improvement and has primary responsibility for the HEDIS data collection process.
In collaboration with the Senior Quality Improvement HEDIS Analyst, this position works with IT to identify solutions and meet deadlines associated with the HEDIS process. The position will work closely with internal partners from the claims, IT, Health Services and Member Services area to ensure the integrity of the plan data.
The QI Manager will be responsible for coordinating with the State for data submission as well as any mandated oversight processes. He/she must have a basic understanding of HEDIS measures as well as a working knowledge of how plan claim, membership and provider data affects the outcomes of the HEDIS measures. The position will be responsible for coordinating all aspects of the process including training of abstractors, IRR,administrative data pulls and manual chart abstraction.
In addition, the QI Manager will assist the Director of Quality and the QI Project Manager in designing and implementing additional Quality Improvement Studies. He/she will contribute to the overall Quality Improvement program by identifying issues and implementing corrective actions when needed. He/she will work with other departments to design initiatives to improve study
results and will lead re-measurement efforts to determine effectiveness.
SKILLS & ABILITIES
Education: Bachelor's Degree (four year college or technical school) Preferred, Field of Study: Nursing or Related Field
Experience: 2 plus years of experience in Managed Care
MediCal and/or managed care.
Data Analysis Experience
Experience in conducting training (small groups or individuals.)
Experience in Quality Improvement activities such as medical record review,
designing and implementing performance improvement projects and/or
utilization management activities.
Experience in developing policies and procedures.
Quality management/regulatory experience with increasing responsibility.
Experience with HEDIS data collection and process.
Knowledge of NCQA health plan accreditation standards and health plan NCQA
Computer Skills: Personal computer skills with knowledge of Microsoft Office software including proficiency in Word,
Excel, PowerPoint, and Access.
If interested, please apply immediately or call directly at 818-531-3416.