Health Care Quality Management Specialist (Remote-Must Reside in FL)

The Health Care Quality Management Analyst implements a quality management strategy that meets internal and external constituent expectations for demonstrating quality outcomes, including NCQA and state regulators for Medicaid and CHIP.  Links the quality management activities to business goals by using innovation, integration, and information. Participates in the development and ongoing implementation of Quality Management (QM) work plans and activities, including support of all accreditation activities and contract requirements.

What you will do

• Support accreditation minimally for health plan, health outcomes, and long term supports and services.
• Support quality contract requirements, including performance improvement projects, analysis of quality improvement activities, and quality program evaluation.
• Assists in the development and implementation of Quality Management projects and activities.
• Converts results of data analysis into meaningful business information to disseminate conclusions about the overall function of the department.
• Support quality committees execution and reporting to quality committees.
• Performs quantitative and qualitative data analysis to achieve operational targets.
• Prepares Quality Management documents that adhere to the interpretation and application of business requirements.

• Must reside in Florida or be willing to relocate to Florida within 3 to 4 months of the start date. Relocation assistance is not provided.
• Minimum 3 years experience in managed care quality and/or provider quality.
• Experience leading or supporting performance improvement projects (PIPs) and/or NCQA accreditation.
• Must be proficient in all Microsoft office Suite, especially Microsoft Excel and PowerPoint.
• Must be analytical and able to interpret data.
• Must be articulate and able to communicate to multiple internal and external stakeholders.