Manager, Quality Member Experience (52646)

Job DetailsJob Location: Any Location Remote US - Oklahoma City, OK 73102Position Type: Full TimeEducation Level: 4 Year DegreeJob Shift: DayPOSITION SUMMARY: Provides guidance, and training to the Quality department and organization-wide staff that impact member experience improvement initiatives. This position will ensure the effective management of member experience survey ratings, including member and provider outreach. ESSENTIAL DUTIES AND RESPONSBILITIES: Develops, plans, and implements initiatives and other quality member experience improvement strategies, making recommendations for change as needed. Directs the member experience processes to ensure the health plan is NCQA-accredited and is a 4+ STAR rating. Ensures pre-CAHPS member surveys are fielded on a monthly basis and communicates results with external provider groups Build and maintain relationships with other departments internally, as well as external provider groups, as it relates to STARS and NCQA. Implements survey improvement initiatives including CAHPS committee meetings to ensure company-wide involvement to increase member survey scores. Creates wellness materials for marketing distribution to aid in member retention and health improvement efforts. Maintains an expert technical understanding of HEDIS, CAHPS, HOS, NCQA and Meaningful Use measures set by CMS performance standards. Manages and monitors performance for CAHPS/HOS survey vendor Develops and implements Medicare AWV/HRA program to increase provider and member participation Sets actionable and achievable goals for Quality Department implementation toward earning and maintaining a 4 STAR Creates training material on member experience surveys for organization-wide staff. Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy. Performs other duties as assigned EDUCATION AND EXPERIENCE: Bachelors degree or equivalent experience required 5-years experience in a clinical or health insurance setting required 5-years experience managing data to create reports required Experience in medical quality, marketing, risk adjustment, coding, and/or wellness preferred Requires a valid state Drivers License KNOWLEDGE, SKILLS AND ABILITIES: Ability to communicate and manage complex working relationships Ability to train internal and external parties Strong organizational, verbal, written, time management, and telephone skills Computer literate and familiar with Microsoft applications (Word, Excel, Outlook) Basic electronic health record knowledge and ability to quickly learn new software Detailed knowledge of quality performance measures and clinical health care Ability to collaborate across departments WORK ENVIRONMENT: This job operates in a clerical, office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. This is a largely sedentary role; however, some filing is required, which would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary. May need to lift to 25lbs. TRAVEL: Required travel to present Quality survey updates to in-network provider groups as well as educational conferences for updates on measures or best practices SUPERVISORY RESPONSIBILITY: This position has no direct supervisory responsibilities but does serve as a coach and mentor for other positions in the organization that contribute to member experience ratings. OTHER DUTIES: This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Qualifications