Job Description

DataStaff, Inc. is currently seeking a Healthcare Process Improvement Specialist for a contract opportunity with one of our direct clients in Raleigh, NC .

Our client works closely with beneficiaries, health care professionals, community leaders and advocacy groups; local, state, and federal entities; and other community partners vested to improve the health and safety of all North Carolinians by providing essential human services. Our client is one of the largest, most complex agencies in the state, with about 17,000 employees.

Our client is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. Our client manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual/developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $27 billion in state and federal funds per fiscal year, our client ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries.

*This contract position requires you to report to Dix Campus in Raleigh 4 times per month.

Responsibilities:

The Quality Improvement Specialist is responsible for the development, implementation, and monitoring of quality improvement initiatives aimed at enhancing healthcare outcomes for Medicaid beneficiaries.

• This position will:Coordinate with key stakeholder teams inside and outside of DHB for enhancement of QI activities
• Identify opportunities for improvement based on analysis of data provided by Health Plans, the State, and other National Data sources
• Provide feedback to leadership on initiatives, KPIs, or potential cross-collaborative opportunities to inform on strategic planning
• Provide Quality Improvement Expertise on Policy Development of Quality Improvement Activities
• Manage relationships with healthcare stakeholders, offering evidence-based recommendations, resources, and ongoing feedback
• Work collaboratively as a Quality Improvement SME with other Business Units to enhance interoperability of Medicaid Quality activities
• Communicate and Collaborate with Health Plans in enhancing member experience and outcomes
• Keep abreast of healthcare quality improvement trends, regulations, and best practices, ensuring compliance with standards such as NCQA, HEDIS, and CMS guidelines.
• Expected to lead 2-3 Quality Improvement activities per 12-month contract
• Participate and support other projects for QPHE

Skills:

• Able to clearly present to other SMEs and non-SMEs on Quality topics and education.
• Advanced analytical capabilities, including the ability to interpret complex data sets and make data-driven strategic decisions.
• Excellent communication skills and ability to engage stakeholders at all organizational levels.
• Proficient in Microsoft Office Suite, especially Excel, PowerPoint, and Word. Familiarity with data analysis tools and software is a must.
• Previous experience with HEDIS Measures.
• Minimum 2-4 years of Quality Improvement Experience preferred.
• Advanced credit given for CPHQ or Six Sigma certification.
• Preferred experience with Managed Care, Medicaid, Medicare, and Accountable Care Organizations
• Preferred experience with understanding of Population Health interventions and outcomes.

This opportunity is available as a W2 position with a competitive benefits package. DataStaff, Inc. offers medical, dental and vision coverage options as well as paid vacation, sick and holiday leave. As many of our opportunities are long-term, we also have a 401K program available for employees after 6 months.

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