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Quality Improvement Project Coordinator (Remote)

Company

Highmark Health

Location

United States, United States

Type

Full time

Description

JOB SUMMARY

The Quality Improvement Department is committed to assessing current systems and processes to ensure the continuous improvement and regulatory compliance of overall health service delivery. This position is responsible for identifying, implementing, and overseeing projects relating to quality improvement/compliance initiatives in one or more of the following primary areas: •CMS Five-Star Rating System and the Quality Rating System (QRS) •Marketplace Exchange Quality Rating Systems (QRS) •NCQA Accreditation and state regulatory compliance •HEDIS

ESSENTIAL RESPONSIBILITIES

  • Thoroughly reviews data, trends, and best practices to identify projects and approaches toward achieving excellence in area(s) of focus, including regulatory compliance, a 4 to 5 Star Rating in the CMS STAR Rating System, a 4 to 5 star rating in the QRS Rating System, and compliance with NCQA Accreditation standards and guidelines.
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