Q1 Coordinator SNP

Company: UPMC Location: Pittsburgh, PA Status: Full Time, Employee Job Category: Medical/Health Career Level: Experienced (Non-Manager) Company: UPMC Reference Code: Job ID: 1032527UPMC is an integrated global health enterprise headquartered in Pittsburgh, Pennsylvania, and one of the leading non-profit health systems in the United States. As western Pennsylvania’s largest employer, with 48,000 employees and nearly $7 billion in revenue, UPMC is transforming the economy of the region into one based on medicine, research, and technology. By integrating 20 hospitals, 400 doctors’ offices and outpatient sites, long-term care facilities, and a major insurance plan, UPMC has advanced the quality and efficiency of health care and developed internationally renowned programs in transplantation, cancer, neurosurgery, psychiatry, orthopedics, and sports medicine, among others. UPMC is commercializing its medical and technological expertise by nurturing new companies, developing strategic business relationships with some of the world’s leading multi-national corporations, and expanding into international markets; including Italy, Ireland, the United Kingdom, and Qatar. For more information about UPMC, visit our website at www.upmc.com. Q1 Coordinator SNP The UPMC Health Plan is seeking a quality improvement coordinator for our Medicaid, Special Needs Plan (SNP) and Children's Health Insurance Program (CHIP).  This position is located in downtown Pittsburgh.  This individual reports to the director, Quality Improvement for Medicaid, Special Needs Plan (SNP) and Children's Health Insurance Program (CHIP).  This position is responsible to support the quality improvement activities related to targeted product HEDIS initiatives.  This position will assist the Director of Quality Improvement and the clinical staff in implementing and monitoring interventions aimed at increasing HEDIS rates.  The scope includes assisting in developing the framework to subjectively monitor the effectiveness of interventions, conducting frequent review of reports to determine the success of interventions and to assist in developing recommendations for improvements.  This position will also be responsible to assist in monitoring and collecting information related to clinical program performance, reviewing performance against goals and developing recommendations for improvement. The quality improvement coordinator assists in the development of plans to address annual changes to HEDIS specifications, by product and also assists the director of QI in revising work plans and developing training programs for clinical staff and providers as needed.  Requirements include a bachelor's degree in a health related field, three years experience in a health care environment, preferably in Managed Care, and demonstrated success in quality management and improvement processes. Computer proficiency in MS Office products and a high level of professionalism in both verbal and written interactions is also required.  Preferences include a valid RN license, experience with HEDIS, leadership skill necessary to facilitate activities from inception to completion and experience working with standards established by accrediting bodies and regulatory bodies such as Department of Public Welfare, CMS, Department of Health and the National Committee for Quality Assurance.  Apply at www.upmc.com by following these steps; click Careers at UPMC, Start My Job Search, and follow the link to continue to search and apply for openings. Select Advanced Search and enter 1032527 in the job opening ID field.  UPMC is an equal opportunity employer.