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 Plan. Preferred NCQA Accreditation experience to include interpretation of the standards, P&P development and maintenance, as well as project management of the survey. Strong analytical and problem-solving skills, with proficiency in data analysis and statistical methods.
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
- Responsible for maintaining full three-year accreditation status and monitoring NCQA accreditation processes/standards. Lead activities including review and interpretation of the standards, monitoring of multiple areas' compliance, as well as developing and implementing quality improvement activities to improve compliance.
- Responsible for collecting, analyzing and interpreting data related to member and provider experience. By utilizing various analytical tools and methodologies, need to identify areas of improvement, produce quality reporting and provide analytical strategies to drive quality ratings improvement for member experience.
- Complete regulatory reporting requirements related to oversight of MCO Quality performance
- Support ongoing quality-related efforts across the Health Plan as determined by Quality Leadership
About Texas Children’s
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.