Job Detail

Quality Improvement Specialist - Medical Billing & Coding

Date Posted: Jul 09, 2024

Job Description

Full Job Description

JOB
What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Under the direction of management, and with minimal supervision, the Quality Improvement (QI) Facilitator II works closely with front line leaders, external partners, and organizational teams to plan, organize, facilitate, and lead quality improvement projects. The QI Facilitator II has a strong understanding of IEHP’s strategic priorities and organizational goals and supports these goals through the development and implementation of QI program activities. The QI Facilitator II will skillfully use techniques of system design, project management, continuous quality improvement (e.g., brainstorming, cause and effect analysis, root cause analysis), outcomes measurements, and data analysis to support the development, implementation, and oversight of QI programs.

Major Functions (Duties and Responsibilities)

1. Lead the facilitation for all levels of IEHP staff, hospital teams, and workgroups in the development and implementation of performance improvement initiatives related to successes in reaching established goals.
2. Oversee and monitor the development, implementation, and outcomes of quality improvement programs.
3. Prepare and present regulatory and committee, and other reports summarizing QI initiatives and the success and/or progress in reaching established goals.
4. Apply and teach standardized QI concepts and techniques to achieve established quality goals for both internally and externally developed quality improvement programs.
5. Lead and support ongoing development of shared organizational and external stakeholders’ quality improvement infrastructure including system design, identification of organizational QI initiatives, tracking of project evaluations/studies, tools, and resources for project monitoring.
6. As a subject matter expert, assess and identify quality gaps and opportunities, facilitates quality improvement initiatives within the organization, and ensures timely project completion and expected outcomes.
7. Translate data into meaningful information, draws conclusions, and relates findings to industry standards. Provides recommendations to departmental stakeholders and QI Leadership Team regarding performance gaps, program implementation, and performance outcomes in order to maintain an effective QI Program.8. Ancillary experience in a hospice or home health setting required.

Required Qualifications:
Minimum of four (4) years demonstrated experience, at a professional level, in process/project management including participation in quality improvement projects or operations.
Master’s degree from an accredited institution required, degree preferably in Public Health, Health Administration, Public Administration, or other healthcare related focus from an accredited institution.
Strong analytical and critical thinking skills. Proficient in all Microsoft Office applications, with an emphasis on Excel, PowerPoint, and Visio.
Strong communication skills (verbal, written and listening) with ability to interact effectively. Ability to successfully apply facilitation techniques to quality improvement project teams to achieve optimal outcomes.
Possesses problem solving, conflict management, and team building skills in order to ensure a productive work environment and achievement of quality goals.
Skilled in reading and interpreting data.
Healthcare quality performance and measurement sets including CMS quality withhold, Managed Care Accountability Set, NCQA Quality Improvement Standards and HEDIS.
Project management techniques, tools of continuous improvement, and work process redesign.
Standard coding sets as they are used in quality measurement including ICD-10, CPT, CPT Category II, HCPCS, LOINC, NDC.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

***Please attach resume or email Juarez-G@iehp.org.


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