Quality Specialist - The Health Plan

Position: Quality Specialist - The Health Plan

Job ID: 402673

Location: US-TX-Houston

Department: Care Coordination I

Talent Area: Professional - Non-Clinical

Full/Part Time: Full time

Regular/Temporary: Regular

Shift: 8:00 AM - 5:00 PM

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.

To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

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 Specialist -- someone who works well in a fast-paced setting. In this position, you will support the development and implementation of the Quality Improvement Program for Program Operations. This role will Implement policies and processes in compliance with all applicable federal, state and nationally recognized accrediting bodies and assist in the reporting of all required quality data to ensure compliance.

Think you’ve got what it takes?

•    Produces reports for quality improvement, guidelines, utilization, and outcomes, error-free and on time
•    Provides healthcare team members with consulting and analysis services to support initiatives intended to achieve breakthrough or incremental process improvement in patient care, as measured by at least one improvement, worthy of storyboard, per center department per year
•    Works with information systems and departmental representatives to evaluate, strategize and ensure data elements are available for collection and reporting
•    Coordinates agenda, meeting minutes and meeting requests for committee meetings, error free
•    Evaluates the effectiveness of Quality Improvement tools when interacting with members of the healthcare team and modifies approach as necessary
•    Successfully facilitates review of documents, e.g. files, which demonstrate the integrity of quality programs
•    Coordinates external reporting, benchmarking, and participation in National Performance Improvement Initiatives
•    Ensures data is available to produce timely and accurate reports for analysis of the complaint process as defined in policy, i.e., for QIC, HHSC, TDI and other quality projects
•    Works on projects, including preparation for health plan wide audits, as delegated by the Quality Management leadership, meeting assigned time frames

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 required
•    3 years’ experience in performance improvement or quality required
•    Experience in a clinical environment preferred
•    Qlik Sense, SQL and Epic preferred
•    Lean 6 Sigma and Intermediate Excel or higher preferred
•    Dashboard Creation preferred

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