Quality Improvement Specialist
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
ABOUT UCAREAt UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities. WORKING AT UCAREWorking at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do. QUALITY IMPROVEMENT SPECIALIST Position DescriptionThis position is responsible for the design, development, implementation, evaluation and reporting of one or more evidence based health improvement programs as they relate to the UCare strategic and annual quality plan. Accountability for leading teams, coordinating and collaborating with internal and external stakeholders, meeting project objectives and reporting to regulatory entities and leadership on project status and outcomes. Responsible for all project management and process improvement activities as they relate to designated projects. Specific duties and responsibilities include: Responsible for project management of complex quality improvement activities. This includes both leading and/or participating as a team member on various projects. Responsible for overseeing and managing project plans, timelines, interventions, quantitative project data, and development of measures to effectively meet the requirements of regulatory agencies. Develop key deliverables which may include, but are not limited to, regulatory reports, presentations and status updates. Responsible for identifying and addressing project barriers and reporting progress to appropriate UCare leadership.Ensure appropriate measurement and data analysis is used for each project. This may include qualitative and quantitative review, barrier analysis of project topic, review of findings as well as actively soliciting provider and member input. Participate in ensuring that UCare is compliant with regulatory requirements for quality. This includes an understanding of applicable State, Federal, and NCQA requirements and the ability to keep updated with any new requirements and to modify projects, as needed. Active participant or leader in internal and/or external collaborative meetings and work groups as they relate to projects. This includes attending and actively participating in external meetings with regulators, other health plans, community, and stakeholder groups. Develop and maintain partnerships with community groups that share a common project goal. Align outreach and initiatives to target health needs in our diverse membership.Provide regulatory quality expertise to external organizations with a business relationship with UCare. This includes oversight for organizations for which UCare has delegated authority or to organizations for which UCare has contractual arrangements for consultation for design and implementation of quality improvement activities.Represent UCare's quality initiatives with key provider groups to develop a mutual understanding of shared quality improvement goals. This may include communicating UCare's quality strategy, gathering information on quality initiatives from the provider groups, and providing expertise, tools, and resources as appropriate.Align with strategic and departmental goals to develop and support new and ongoing project efforts as they relate to the Quality Improvement team. This includes, but is not limited to, Performance and Quality Improvement Project (PIP and QIP) development, delegated quality activities, Pay for Performance strategies, HEDIS, NCQA, delegation oversight, surveys and other quality initiatives.Provide education and tools to improve company knowledge of quality improvement and processes. Define appropriate measures of processes and outcomes. Maintain knowledge of industry trends and practices. Other projects and duties as assigned.EducationBachelor's degree in business administration, health care, information systems, social sciences, public health or other related field required. Master's and/or nursing degree preferred.Required ExperienceTwo years of experience in quality improvement and five or more years of experience in health care delivery system. Demonstrated process improvement and project management skills. Strong verbal and written communication skills.Preferred ExperienceFormal training in quality improvement and/or project management. Education in statistical analysis and experience in a managed care or health insurance setting. NCQA accreditation experience.THE UCARE DIFFERENCEUCare is proud to be a recognized Star Tribune Top Workplace for the 8th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply. As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.