The MSO Quality Improvement (QI) Specialist is responsible for providing support for quality assessment and performance improvement activities that include quality monitoring, evaluation and facilitation of quality improvement projects.
The MSO QI Specialist is required to have superior ability to communicate effectively with a variety of professionals, including providers and administrators. Knowledge of managed care, Medi-Cal and Medicare is strongly preferred.
· Coordinate and participate in QI projects including the Practice Improvement Programs (PIP), inter-rater reliability studies, provider utilization studies and other surveys and studies
·Compile statistical data collected from medical records, logs and databases studies that support the QI projects
·Ensure the integrity of data being reported and utilized is accurate and valid
·Perform statistical data analysis and interprets the data
·Identify opportunities for improvement and make recommendations to improve quality outcomes
·Assist in the design of QI plan for improvement efforts
·Implement QI activities to improve outcome in accordance with project design
· Monitor outcome of QI activities and propose changes if desired outcome is not achieved
·Develop summaries and generate effective and optimal visual display to inform business partners about findings
·Convey complex clinical and technical information both verbally and in writing effectively and to produce high quality reports and documentation
·Work collaboratively with physicians, staff and external organizations to improve quality outcomes
·Participate in applicable internal and external committees and prepare meeting materials as needed
·Comply with regulatory and licensing agency requirements and promptly inform the applicable person(s) of changes and updates
· Update policies and procedures as needed to meet QI project requirements
· Submit QI reports to internal and external business partners as required in a timely manner
· Perform duties as assigned by Manager, Director, and the President & CEO
· BA/BS Degree in Social Sciences, Business or General Education with minimum two years experience working in healthcare setting, or equivalent combination of education and experience
· Associate Degree may be considered with relevant, equivalent work experience
· Excellent communication skills (spoken and written) to effectively communicate with a variety of professionals, including providers, administrators and others
· Must be PC literate - Strong Excel, Word, Power point, and Outlook skills
· Knowledge of managed care, Medi-Cal, Medicare and other state-sponsored health programs is strongly preferred
· Prior experience in a managed care setting or provider organization preferred
·Knowledge of QI standards, regulatory requirements, measurement tools, and techniques, including collection, aggregation, abstraction, validation, analysis, and reporting of data required
·Detail oriented with ability to effectively manage time, see projects through to completion and organize competing priorities
·Strong critical thinking and problem solving skills to manage multiple levels of information and responsibilities, to quickly assess issues as they arise, and to develop timely and effective solutions
·Strong interpersonal skills for collaborating effectively with a broad range of clinical and non-clinical staff
· Must be able to fluently speak, read and write English.
· Fluent in Chinese (Cantonese and Mandarin) required.
· Fluent in other languages are an asset.