HEDIS & QARR Quality Supervisor - (US-NY-albany - 12288)

Minimum Education: Bachelors
Job Type: Full Time
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HEDIS & QARR Quality Supervisor

We have been retained by our client to assist them in finding a HEDIS & QARR Quality Supervisor. Salary is negotiable based on experience. This position is located in Albany, NY.

The HEDIS & QARR Quality Supervisor is responsible for the overseeing the day to day operations of the Quality Department including NCQA, HEDIS, Medical Record Studies, practice guidelines, delegation oversight and other activities related to quality of care measurement. The Supervisor will lead quality improvement teams to achieve and maintain the quality and performance goals of the plan and will develop, implement and evaluate effective quality programs.

Duties and Responsibilities:
• Supervise 6 employees including the Quality Review Nurses, Quality Coordinator, Member Complaints Coordinator and other support staff
• Manage the HEDIS project and actively participate in all aspects of HEDIS to ensure that HEDIS is carried out successfully and passes the annual audit
• Assist in developing strategies surrounding the improvement of the HEDIS process
• Manage the development, implementation and evaluations of clinical practice guidelines and preventive health guidelines
• Coordinate and monitor HEDIS outreach efforts in all company departments
• Manage the member clinical complaints plan and make sure that regulatory requirements are met in regards to turnaround time
• Ensure the appropriate policies and procedures are in place to support all quality improvement activities
• Oversee all vendor activities including data collection and medical record review
• Oversee the temporary HEDIS nurses
• Work with providers and members to improve the quality of care

Qualifications:
• Bachelor of Science degree in Health Informatics Specialization or Health Management preferred
• RN or NP with valid NYS registration or license is preferred
• Minimum of one year experience in a management/supervisory capacity related to Quality and HEDIS projects in an HMO, Managed Care Organization and Indemnity OR related health industry experience preferred
• Minimum of 3 years experience with HEDIS measurements, annual reporting, medical record reviews and HEDIS auditing preferred
• Experience in quality improvement in healthcare preferred
• Experience with data retrieval, analysis, statistics and reporting preferred
• Expertise with regulatory requirements of DOH, CMS, DOL, NCQA
• Proven experience in successfully managing and training staff
• Deadline driven, ability to handle multiple projects simultaneously
• Knowledge of NCQA accreditation standards and processes, NYS DOH, NYS DOI and CMS managed care requirements



Linium’s commitment to Excellence, Integrity and Expertise is unmatched in the Capital Region. Linium is an equal opportunity employer matching exceptional talent to superior companies throughout the Northeast for over 25 years.

The ability to find the missing piece



To apply, please send your resume to Jennifer Stonehouse, Professional Resource Manager
Phone: 518-689-3159
Fax: 518-689-4882
Email: jennifer.stonehouse@linium.com

We welcome walk-in candidates!
Visit our website to learn more about our current job opportunities!
www.liniumstaffing.com