About Texas Children's Hospital
Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
We are searching for a Quality Improvement Specialist -- someone who works well in a fast-paced setting. In this position, you will facilitate process improvement. This includes leading process improvement using QI methodology, coordinating quality improvement committees and advisory committees, completing regulatory reporting requirements, NCQA accreditation experience and leading provider site process improvement. This role will also serve other operational duties to meet the QI needs of the Texas Children's Health.
Skills & Requirements
Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s unless approved for a medical or religious exemption
- Bachelor's Degree
- 1 year of Project management or process/quality improvement experience
Job Duties & Responsibilities
- Lead process improvement to meet assigned objectives defined by the Quality Improvement Program (QI Program)
- Lead and optimize TCHP’s proactive and regulatory data collection to improve performance on HEDIS and CAHPS survey measures
- Coordinate and support TCHP’s Quality Improvement Committee and external advisory committees
- Lead process improvement at provider sites to support provider’s performance on high impact quality measures and adherence to clinical practice guidelines
- Lead provider audit activities to advise corrective action in response to complaints or concerns regarding a provider in TCHP’s provider network
- Complete regulatory reporting requirements related to oversight of MCO Quality performance
- Regulatory HEDIS Support
- Support ongoing quality-related efforts across the Health Plan as determined by Quality Leadership
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