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QHI Coordinator - NCQA Emphasis

Network Health is seeking a QHI Program Coordinator with an emphasis in NCQA. This individual will The QHI Program Coordinator will assist in developing and monitoring the quality improvement plans such as CMS Star Ratings, HEDIS, QRS, NCQA, etc. to maintain high quality of care and service for all Network Health Medicare Advantage, Commercial and Marketplace members.  This position will provide support for all documentation and data related to Quality Programs. This position will collaborate closely with the Quality Programs Manager, Quality Analytics, and other department leads on all projects and meetings to support quality programs.

Job Responsibilities:

Develop and monitor information and data in relation to the tactical work plans for the CMS Medicare Star Ratings technical specifications as well all other Quality Programs technical specifications.
Develop and provide documentation for trainings to Network Health staff to improve overall knowledge and understanding of Quality Programs with Training as needed.
Collaborate with quality program managers, other coordinators, and analysts to create work plans to excel all quality programs
Creates materials, workplans, presentations, and documents to help support quality programs
Maintain documents and data related to NCQA, Medicare and Marketplace Stars from various sources
Identify risks to quality program early and collaborate with QHI Manager to create a plan and present findings to inform and educate business owners and leadership
Assist with strategies for Clinical Integration programs related to all quality programs
Proactively analyze and implement actions related to network expansion efforts as it relates to all quality programs
Collect, review, and analyze documentation related to NCQA accreditation. Bookmark and submit evidence for NCQA survey. 
Participate in quality committees such as QMC
Assist with health equity work as it relates to any quality program
Other duties as assigned

 Job Requirements:

Bachelor’s degree or equivalent years of experience
Minimum of 3 years of experience working in health care field, quality and/or related fields.
While not required, the following experience is preferred:
A minimum of 2 years of experience in healthcare quality.
Project management experience.
Experience in reviewing and interpreting Medicare guidelines or other regulations.
CMS Stars experience, or relevant experience.

Time:  Full time
Salary:  Hourly
Category:  Clinical/pharmacy/quality

Updated: 2/3/2023 9:59:14 AM

Job Contact:
Jackie Rosen

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1570 Midway Pl
Menasha, WI 54952