Quality Improvement Analyst

The Quality Improvement Analyst is responsible for assisting in the development and monitoring of the organization's quality management activities.

DUTIES

Major responsibilities will include monitoring the UM functions and working closely with the Manager of Quality Management to establish departmental goals and compliance. The Quality Improvement Analyst of UM/UR will work closely with staff to evaluate necessity, appropriateness, and efficiency of services for our clients while following insurance guidelines. This position will be responsible for maximizing efficiency of services while following insurance guidelines. This position will be responsible for maximizing efficiency of the services with consistent processes along with identification of operational issues including systems issues to be addressed. This position requires the use of discretion and independent judgment in executing all job duties. This position is part of the Quality Department and reports to the Supervisor of Quality Management.

QUALIFICATIONS

To be considered for this exceptional opportunity, the ideal candidate will:

Have time management and task prioritization skills.

Possess effective communication skills, both written and verbal with specific ability to maintain accurate records.

Have Program planning, implementation and monitoring skills.

Knowledge of clinical workflow or at least one year of hands-on clinical experience to understand the client/patient care process.

Have a strong understanding of state and federal health care laws and regulations.

Have data collection skills and knowledge of basic statistical principles.

Possess an understanding of clinical terminology.

Have a minimum of two years of experience in a healthcare environment.

Have a minimum of one year of experience with electronic health record systems.

Have experience in UM/UR, process improvement, total quality measurement, or as a member of a quality improvement committee strongly preferred.

Have strong working knowledge of MS Office Suite including Word, Excel, Project, Visio and PowerPoint. Experience with SharePoint preferred.

Must have excellent communication skills and the ability to communicate effectively with funding source representatives and staff.

Must be skilled in establishing and maintaining effective working relationships with participants, co-workers, medical staff and the public.

Excellent organizational and leadership skills.

Must have experience extracting data from both paper and electronic health records with an ability to transform data into story to develop action plans.

Must have excellent analytical and problem solving skills with strong attention to detail.

Must be able to adapt quickly to change.

Must be able to coordinate, monitor and prioritize multiple tasks.

Have the ability to work independently, coordinate multiple tasks, prioritize work and manage time to accomplish tasks with multiple interruptions.

Must have the ability to assess community needs, and participate in the creation of programmatic responses.

Must have excellent customer skills.

Must have integrity, practice discretion and practice objective problem solving.

Must be skilled in identifying and recommending problem resolution.

Must be able to have flexible schedule including possible evening hours.

Bachelors Degree from an accredited university or college in Social Work, Public Health or closely related degree strongly preferred.

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