Quality Improvement Resume Samples
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Quality Improvement Resume Samples
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ED
E Douglas
Emma
Douglas
9438 Rosenbaum Road
Chicago
IL
+1 (555) 518 6286
9438 Rosenbaum Road
Chicago
IL
Phone
p
+1 (555) 518 6286
Experience
Experience
Detroit, MI
Quality Improvement Analyst
Detroit, MI
Cronin, Bailey and Beatty
Detroit, MI
Quality Improvement Analyst
- Proven track record of success managing/working within multidisciplinary teams
- Oversee and coordinate the web liaison program for BHPL, including but not limited to posting time sensitive alerts and important public Board materials
- Work with the clinical areas to develop more automated reports for customer reporting and operational decision making
- Responsible for QI Program database including maintenance, enhancements, trouble shooting, and communication with developer
- Assist in BHPL website development including recommendations for uniformity and consistency throughout BHPL pages
- Collaborate with Director and team in development of QI initiated projects and/or other human subjects research management projects. For example, based on observed noncompliance at the Investigator site, develop tools or program services to proactively assist Investigators
- Maintain QI Program website to accurately reflect QI Program activities. Act as liaison with IT/IS to ensure website is maintained
Phoenix, AZ
Manager, Quality Improvement
Phoenix, AZ
Funk Group
Phoenix, AZ
Manager, Quality Improvement
- Manage the development, implementation, and evaluation of Quality improvement action plans for clinical quality improvement activities
- Manage the development and realization of HEDIS, CAHPS action plans to achieve target improvement goals
- Prepare reports and records on work function activities for management
- Performs annual update on state Plan Risk Management Program Description
- Manage the analysis and action planning related to the member/provider satisfaction survey process
- Develop and monitor Quality Management budget
- Contributes to new business activities (RFP responses, new program development, and employer group and government marketplace/exchange contract changes etc.) related to quality improvement
present
Los Angeles, CA
Regional Director, Quality Improvement
Los Angeles, CA
Abernathy LLC
present
Los Angeles, CA
Regional Director, Quality Improvement
present
- Remains current concerning industry-wide, clinical care leading practices and evaluates for implementation at the facility
- Ensures and supports each hospital in adhering to NPSGs. Collaborates with Risk management for related safety activities and process implementation
- Provides orientation for new DCQIs and monitors ongoing progress
- Provides coaching and guidance to hospital DCQIs
- Provides input for strategic development, planning and implementation of regional and hospital quality plans
- Current nursing licensure in state of practice
- Provides regional leadership and expertise in methods of quality improvement
Education
Education
Bachelor’s Degree in Related Field
Bachelor’s Degree in Related Field
Central Michigan University
Bachelor’s Degree in Related Field
Skills
Skills
- Ability to effectively present information and respond to questions from peers and management
- Ability to effectively present information and respond to questions from families, members, and providers
- Ability to develop and give presentations and to assume the role of facilitator
- Demonstrated ability to develop and lead effective teams with experience managing large scale organizational change
- Ability to lead/manage others
- Prepares, compiles, reviews and submits monthly and quarterly reports for quality committee meetings
- Ability to influence internal and external constituents
- Ability to effectively present information and respond to questions from families, members, providers, peers and management
- Ability to multi-task
- Ability to work in a fast paced environment with changing priorities
15 Quality Improvement resume templates
Read our complete resume writing guides
1
Corporate Quality Improvement Analyst Resume Examples & Samples
- B.A
- 3+ years related experience
- Exposure to Quality Improvement, QARR/HEDIS, Health Plan, Medicare & Sr Programs
- RN / MPH
- CSW / LCSW
2
Medical Director, Quality Improvement Resume Examples & Samples
- Providing overall medical expertise to ensure continuous quality improvement; cost-effective service to subscribers, maintenance of effective provider relations, and development and implementation of Utilization Management and Complex Case Management programs
- Accountability for developing clinical innovations and assures the implementation of enterprise policies and procedures, and the achievement of business plan goals in areas of accountability
- Involvement in the Continuous Quality Improvement Committee, Quality Peer Review Committee
- Developing and implementing provider education programs related to clinical quality improvement activities and Complex Case Management activities for all population
- Developing programs to improve the performance of providers related to clinical performance reports
- Board certified MD or DO
- Managed care & managerial experience board certification
- NCQA/QM
- Knowledge of Utilization Management, Continuous Quality Improvement, Complex Case Management programs and principles of prevention and wellness
- Knowledge of NCQA Standards and experience in successful plan accreditation
- Familiarity with ICD-9 and CPT Coding
3
Quality Improvement RN Resume Examples & Samples
- Quality Improvement, Oasis, Home Care and CHHA
- 2 years CHHA
- RN or BSN
- Knowledge of and proficiency in computer applications, word processing, statistics, state and federal regulation
- Coding OASIS
4
Clinical Quality Improvement Director Resume Examples & Samples
- Experience with clinical nursing
- Experience with patient safety and quality improvement
- Experience with planning, implementing, and evaluating large-scale clinical performance improvement efforts
- Experience with program evaluation and data analytics
- Experience with working in a direct client-facing role
- Experience with Microsoft Office
- Ability to build trust with the client and working relationships with onsite staff for contact with senior government leadership
- Ability to be detail-oriented and flexible and to multitask and be proactive
- Ability to quickly adapt to changing client priorities and respond to ad hoc requests
- Experience with military healthcare or working with military leadership
- Experience as an RN preferred
- BA or BS degree in a healthcare field
5
Quality Improvement Frontline Leader Resume Examples & Samples
- Current RN license in the state in which the nurse is/will be required to practice
- Ability to be licensed in multiple states without restrictions
- Strong interpersonal & relationship building skills
- Strong analytical skills, able to manipulate and interpret data
- CMS Stars/performance measures/HEDIS knowledge and experience
- Office practice/ hospital experience
- Organizational and prioritization skills
- Previous management/supervisory experience
- Experience in educating new employees/continued education to employees
- BSN or Bachelor’s degree in a related field
- Previous clinical or health plan operations experience, including progressive leadership roles
- Prior Medicare/Medicaid experience
- Proven organizational, communication and community relations skills and the ability to communicate (oral and written) and work effectively with a diverse community
- CPHQ certification
- Utilization management knowledge and experience
- Understanding of clinical programs
- Coding knowledge and experience
- Provider and member rewards program knowledge and experience
6
Quality Improvement Analyst Resume Examples & Samples
- Previous health insurance industry experience working in a reporting / analytics department
- Proven ability to manage translational databases
- Significant knowledge of and experience with HEDIS and CAHPS data specifications and reporting
- Experience and background in coding conventions (HCPCS, ICD-9, CPT)
- Experience in design and implementation of large population study analyses
- Proven track record of success managing/working within multidisciplinary teams
- Basic knowledge, experience SQL, SAS language would be a plus
7
Quality Improvement Resume Examples & Samples
- Responsible for the management and direction of the HEDIS, CAHPS and STARS initiatives
- Establishes quality improvement objectives to meet the demographic and epidemiological needs of the population served and provide high quality and culturally appropriate care
- Ensures compliance with federal, state, and accreditation standards by developing, implementing and maintaining compliance processes within the department
- Ensures necessary steps are taken to achieve a successful year over year improvement of HEDIS measures
- Works collaboratively with key health care professionals toward identification of opportunities for improvement, trend analysis, education that result in the development of appropriate action plans for problem resolution
- Serve as a resource working with research staff in study design, data collection, analysis, and reporting activities that support quality improvement interventions, transparency, compliance regulatory standards, and provider performance monitoring
- Represents HEDIS department by participating in assigned committees and interdisciplinary workgroups
- Registered Nurse (RN) or LPN will be considered who possesses strong relevant experience
- 3+ years’ experience in Utilization and Quality Improvement
- HEDIS experience
- Strong critical thinking skills, communication skills, and documentation skills
- Statistical ability to analyze data
- Strong computer skills and experience with Microsoft Office Suites including the development of spreadsheets
- BSN or Bachelors degree in a related field
- Health Plan experience
- Prior Medicare / Medicaid experience
- Call center or triage experience
- May substitute equivalent education and/or experience for degree
- Previous experience in utilization management, discharge planning and/or home health or rehab
- Bilingual is a plus
8
Quality Improvement Auditor Resume Examples & Samples
- Conducting internal audits of policies on CHP Recertification and quality of work in all areas of Enrollment transactions
- Reviewing applications for accuracy and completeness and reviewing all documents to ensure receipt and that they are within the required timeframe
- Performing ad-hoc projects and duties
- Comfortable performing repetitive actions
- Excellent organization/time management skills in order to multi task and work on computer applications
- Good written and oral communications skills
9
Quality Improvement Outpatient Coordinator Resume Examples & Samples
- 1+ year of Clinical Patient Care experience
- NY Registered Nurse (RN) license
- Experience in Quality Improvement and/or Risk Management
- Solid Project Management skills
- Microsoft Office/Suite proficient (Excel, PowerPoint, etc.)
- Previous Leadership experience
10
Medicaid Quality Improvement Market Consultant Resume Examples & Samples
- Develop and maintain a market clinical quality improvement plan, in conjunction with market and corporate partners
- Consult with data and analytics teams to inform development of performance reporting
- Monitor and share performance data with stakeholders and facilitate multi-disciplinary discussions of performance patterns/trends
- Collaborate with Task Force teams to help shape measure level initiatives to address market-specific barriers and opportunities
- Inform and support market quality teams during the quality improvement initiative implementation process
- Communicate and collaborate with market, clinical and Medicaid leadership on all aspects of planning that impacts Medicaid quality performance (e.g., Plan Design, network management, provider rewards, etc.)
- Make every effort to support ad-hoc needs and requests
- Bachelors degree
- Ability to interpret and leverage data to generate value added insights
- Team Orientated
- Excellent PC skills (including MS Excel, PowerPoint, Word
- Clinical Background
- Quality Improvement experience in managed care or health care administration
- Knowledge of Medicaid / Duals is highly desired
- Working knowledge of process improvement methodologies (e.g. Six Sigma, TQM)
- Experience with any of the following applications: MS Access, SAS, ClickView
11
Senior Manager Quality Improvement Resume Examples & Samples
- BS in Engineering preferred or related technology field
- 8+ years of management experience within software quality and process
- Experience with 8D methodology, RCA, or 5-why methods of problem identification
- Excellent communication skills: presentation, conflict resolution, customer focused, can communicate with all levels
- Experience in Agile development and deployment methodology
- Experience with Lean Six Sigma methodologies a plus
- Green belt or Black belt certification a plus
- Experience with A-Spice and ISO 9001 standards and application within a software environment a plus
12
Quality Improvement Organization Liaison Resume Examples & Samples
- Manage network participation, care with specialty networks, care with DME providers and transfers to alternative levels of care using your knowledge of benefit plan design
- Recommend services for Humana Plan members utilizing care alternatives available within the community and nationally
- Identify potentially unnecessary services and care delivery settings, and recommend alternatives if appropriate by analyzing clinical protocols
- Examine clinical programs information to identify members for specific case management and / or disease management activities or interventions by utilizing established screening criteria
- Conduct admission review, post-discharge calls and discharge planning
- Active RN license in the state(s) in which the nurse is required to practice
- Ability to be licensed in multiple states without restrictions
- Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
- Ability to work independently under general instructions and with a team
- Valid drivers license and/or dependable transportation necessary (variable by region)
- Education: BSN or Bachelor’s degree in a related field
- Health Plan experience
- Previous Medicare/Medicaid Experience a plus
- Call center or triage experience
- Previous experience in utilization management, discharge planning and/or home health or rehab
- Bilingual is a plus
13
Quality Improvement Team Leader Resume Examples & Samples
- Lead PODS strategic and tactical planning in conjunction with the PODS Corporate Team
- Work collaboratively with Northeast’s Quality Stars Leader in the implementation of various STARS initiatives and projects
- Work collaboratively with the Northeast’s Health Service Organization leadership in the coordination of HEDIS Gap closure, member facing care coordination and other clinical quality projects
- Oversee day to day operations and human capital of the Northeast’s PODS organization
- Lead PODS Owner Team Meetings to discuss questions, process changes etc
- Develop team members and creating department process flows
- Assists PODS Owners as necessary in the completion of tasks and assignments to ensure continuity of service
- Facilitate internal meetings for PODS Owners to understand pertinent depts. within Humana
- Weekly review of PODS Owner metrics/productivity and coach to individual needs based on performance
- Guide PODS Owners on appropriate collaboration with analysts/ PR/MRA/CS etc
- Work with Quality Analyst to determine efficient means for PODS Owners to access PODS Reports
- Continual redistribution of workload (TINs) to PODS Owners in appropriate areas as needed
- Oversee the design and implementation of PODS performance outcomes and productivity metrics
- Achieve performance metrics for PODs (team) under the triple aim model, cost containment, documentation and Quality
- Assure compliance with mandated and corporate policies regarding other departmental areas such as medical management, utilization management and case management
- Assume responsibilities as a POD Owner by effectively developing, enhancing and maintaining key provider clinical relationship in the down state New York Market (5 Boroughs, Nassau and Suffolk Counties, Westchester)
- Progressive experience in the health solutions industry, with emphasis with leading and managing teams
- CMS Stars/performance measures/HEDIS knowledge and experience
- Proficiency in analyzing and interpreting financial trends
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and Access
- Bachelor’s Degree in Business, Finance or a related field
- Nursing Degree RN
- Master’s Degree in Business Administration or a related field
14
Stars Quality Improvement Analyst Resume Examples & Samples
- Work with IT, 3rd party vendors and other business teams to ensure completeness, accuracy and timeliness of all data required to optimize Humana Star ratings
- Work to develop more timely and automated operational reporting
- Work with markets to obtain the critical data needed to improve Star ratings
- Identify and evaluate data trends
- "Tell the story" of each initiative demonstrating action plans and results
- Contribute to the cross-functional Stars Task forces
- Maintain strong working relationship with internal and external stakeholders
- Create, manage and maintain detailed program, process and project design documents and task-level plans to organize cross-functional teams
- Comprehensive knowledge of all Microsoft Office applications such as Microsoft Word & PowerPoint
- Must be able to do the following in Excel: Must be able to analyze large data sets
- Must be able to do the following in Access: Must be able to run complex queries in Access, such as Cross Tab Queries and Query Joins
- Experience with database queries
- Excellent communication skills due to high exposure across Humana and external networks
- Proficiency in analyzing and interpreting trends
- Experience interpreting and leveraging data in effective decision making
- Must be comfortable presenting to senior level leadership frequently
- Ability to self-motivate and provide self-direction / self-starter
- Prior work experience in the healthcare industry
- Process mapping and process management experience
- Visio / Process Mapping
15
Quality Improvement RN Resume Examples & Samples
- Promote population health management by educating our engaged providers on opportunities for quality improvement in partnership with other functional areas
- Medical Record Reviews for quality opportunities, including record retrieval and submission where gaps are identified via the medical record reviews
- Assess data, identify opportunities, and understand how to drive successful outcomes
- An active RN license in the Florida
- Knowledge and experience with CMS Stars performance measures, and HEDIS
- Strong organizational skills, and the initiative to work without the need for detailed instruction (self -starter)
- Effective in communication, both internally and externally to Providers as it relates to quality findings
- Expert in Microsoft (Word, Excel, Power Point, Office, Sharepoint)
- Ability to travel to local market area provider offices for access to Medical Records when electronic retrieval is unavailable
- Savvy in Technology and Data Interpretation
- BSN or Bachelor’s degree
- CPHQ certification
- Fast paced, goal driven, understanding of start-up environment
16
RN, Quality Improvement Resume Examples & Samples
- Interact with providers, in person and virtually
- Problem solve gaps in quality measures
- Conduct chart reviews
- May do some HEDIS & auditing
- HEDIS experience
- 2-3 years clinical experience
- Good research and analysis skills
- Excellent communication and computer skills
17
LPN Quality Improvement Resume Examples & Samples
- Active LPN or LVN license in the state(s) in which the nurse is required to practice
- Diversified clinical experience
- Experience in quality improvement measures
- Strong communication and analysis skills
- Adaptable to changes in a dynamic environment
- Experience interacting with providers on an educational level
- Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana At Home's systems if 5Mx1M
- Managed care experience
- Experience with HEDIS and Stars
18
Commercial Quality Improvement Analyst Resume Examples & Samples
- Bachelor's degree in Business, Engineering, Math, Health Administration, Accounting or related field
- Prior experience working in a system analytics and/or data warehousing environment
- Strong written and oral communication skills required
- Excellent PC skills (including MS Word, Excel and Access)
- Working knowledge of Commercial products
- Data driven
- Technical skillset with the ability to take data and manipulate to get to root cause analysis
- Strong relationship building with high aptitude for executive leadership
- Execute data management for market relations
- Strong project management background
- Experience in business writing or creative writing
- Experience in managed care or health care administration
- Previous Clinical background
19
Physician Office Quality Improvement RN Resume Examples & Samples
- Develop, facilitate, and/or secure opportunities to positively impact Triple Aim (cost/quality/documentation)
- Partner with Care Management nurse and physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education
- Provide resources and educational opportunities to provider and staff
- Look beyond metrics to identify underlying issues that contribute to gaps
- Prioritize Analyst work for specific reporting
- Assess data, identify opportunities, and understand how to drive successful Triple Aim outcomes
- Active KS RN license without restrictions
- Experience working with Core Measures, HEDIS, HOS and/or CAHPS surveys, JCAHO, and CMS or other regulatory guidelines
20
Quality Improvement Project Manager Resume Examples & Samples
- Apply internal processes and enforce project standards
- Review expectations/deliverables prepared by senior leadership/ business owner
- Coordinate deliverables with business owner
- Coordinate project plan and drive towards deliverables
- Develop clear and concise documentation
- Provide strong organization and effective communication skills (oral and written)
- Facilitate regular status meetings with business owner/project teams/steering committees
- Manage task/action item priorities
- Report progress of project deliverables and milestones which will be shared with in a format which is passed along to Senior Leadership
- Manage timely decisions to support project
- Proficiency in communicating effectively with project stakeholders up to and including leadership
- Obtain additional knowledge by asking questions, exploring different options, being creative and thorough, and open to new ideas
- Regular use of Microsoft PowerPoint, Word, Excel, Project, Outlook, SharePoint and Visio
- Have knowledge of and ensure completion of departmental intake forms when applicable
- Adoption of Process Discipline philosophy and utilization of project management related support material
- Project Standards: (Charter, RACI Model/Roles and Responsibilities, Governance Structure, Project Plan, Risk/Issues Tracking)
- Ability to manage stakeholders and hold them accountable for deliverables
- Ability to execute tasks captured in a project plan
- Experience creating project plans while ensuring timelines and deliverables are being met
- Strong communication skills both verbally and written
- Project Management Institute certification - PMP
21
Manager, Quality Improvement Analytics Resume Examples & Samples
- Genuine positivity, enthusiasm, and affability
- Uncompromising professionalism and discretion with maturity and grace
- Comfort with ambiguity and extensive, active problem-solving and critical thinking capability
- Highest attention to detail
- Natural drive and initiative, a strong work ethic, and high productivity
- Highest proficiency in technical skills
- Healthy and always positive interpersonal skills
- First-class customer service; and
22
Quality Improvement Resume Examples & Samples
- Accomplishes an on time and seamless project implementation with full Team participation
- Tracks project milestones, identifies problem areas, & coordinates corrective actions. Communicates with service line operations and key stakeholders in all relevant areas of projects and initiatives
- Acts as a resource person for the HLV & SOTP Service Line for the various applications. Abstracts/validates moderate to complex data elements for the UNOS registry and various databases. Enters data and submits in an accurate and timely fashion. Seeks advanced training in project management and quality improvement and safety
- Participates in PI efforts, either within the department or within a larger PI team, related to HLV/SOTP data collection and reporting
- Educates and mentors nursing and ancillary staff in evidence-based practice and new emerging trends
- Handles project team issues through established escalation processes applying resolutions appropriately. Demonstrates ability to act decisively and take effective action in a timely manner
- Serves as a change agent, engaging process teams in a non-confrontational, collaborative, consensus driven approach
- Other Duties: Performs other duties as assigned
23
Treasury Quality Improvement Analyst Resume Examples & Samples
- Performs treasury financial analysis involving cash funds, foreign exchange, debt and capital management
- Assist with the design and implementation of internal controls and process improvements across entire capital process
- Implement processes to promote quality and accuracy over other activities within the Corporate Treasury division
- Collaborate with other groups in Treasure to support objectives
- Identity and implement enhancements to create efficiencies and streamline treasury processes
- Monitor the effectiveness of implemented enhancements and provide updates through reporting
- Stay well informed of regulatory and industry updates regarding Treasury topics
- Assist other areas of the team during peak production cycles
24
Hedis Quality Improvement Analyst Senior Resume Examples & Samples
- Requires a BS/BA degree in a related field
- 3-5 years of data analysis, NCQA accreditation standards and HEDIS technical specifications; or any combination of education and experience, which would provide an equivalent background
- RN license preferred
- Proficiency in MS Excel preferred
- Chart audit experience preferred
25
Quality Improvement Analyst Resume Examples & Samples
- Responsible for data analysis and interpretation of QI Program metrics. Metrics generally include QI observations made at Investigator site and program service demand
- Generate and develop, in conjunction with Director, QI metric reports and ad hoc requests to various levels within the HRPP including QI Program, Institutional Review Board (IRB), and senior leadership
- Lead QI quarterly and annual discussions of systematic improvements based on data analysis
- Maintain and develop educational material, QI workshops and lectures for the Partners research community based on QI program metrics, in conjunction with Director
- Collaborate with Director and team in development of QI initiated projects and/or other human subjects research management projects. For example, based on observed noncompliance at the Investigator site, develop tools or program services to proactively assist Investigators
- Maintain QI Program website to accurately reflect QI Program activities. Act as liaison with IT/IS to ensure website is maintained
- Responsible for QI Program database including maintenance, enhancements, trouble shooting, and communication with developer
- Maintain, update and develop QI Program procedural manuals
- Participate in routine on-site reviews and directed study site audits as needed
- Participate in orientation lectures and continuing education for clinical research personnel
- Use the Partners HealthCare values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration
- Bachelor’s degree required, master's degree in related field preferred
- 3+ years of experience in clinical research
- Knowledge of federal and state regulations governing clinical research, and Good Clinical Practice guidelines
- 2 - 3 years applied experience in reading/writing SQL programming language for developing queries and maintaining databases
- Advanced understanding of Excel and Access analytical tools and formulas; design experience preferred
- Demonstrated experience in statistical techniques and methods for analysis, interpretation, and making recommendations from program data
- Possess strong interpersonal skills to effectively communicate with cross functional teams including staff at all levels of the organization, including research staff
- Strong organization and negotiation skills
- Requires minimal direction from leadership and possesses the ability to learn quickly
- Ability to successfully negotiate and collaborate with others of different skill sets, backgrounds and levels within and external to the organization,
- Ability to be flexible and adapt to shifting priorities
26
Senior Manager, Quality Improvement Resume Examples & Samples
- Develops, implements and maintains a standardized quality management plan and program to ensure compliance with external regulatory and accreditation requirements
- Ensures high risk, high volume, and unusual events are monitored concurrently and retrospectively as they occur
- Manages and evaluate performance of staff related to clinical and health care services performance improvement activities. Provides department orientation to new staff and ongoing staff development to the entire department
- Maintains a knowledge base of HEDIS requirements and implementing clinical performance methods to improve HEDIS performance
- Coordinates all external programmatic oversight visits for contracted providers and ensures timely completion and follow up on corrective action plans
- Participates in the development, review and updating of policies and procedures
- Develops and analyzes reports to monitor and evaluate quality performance in meeting established goals related to quality improvement plan and contractual requirements
- Provides guidance and training to new associates
- Completes the state Licensed Health Care Risk Management certification program
- Performs annual update on Florida Plan Risk Management Program Description
- Coordinates the regular and systematic review of all potential adverse incidents in accordance with state statute
- Required A Bachelor's Degree in HealthCare, Nursing, Public Health, Health Administration or directly related field
- Preferred A Master's Degree in a related field
- Required 7+ years of experience in directly related Quality Improvement job duties
- Required 4+ years of experience in Managed Healthcare
- Required 2+ years of management experience
- Intermediate Knowledge of community, state and federal laws and resources
- Required Intermediate Microsoft Word
27
Quality Improvement Analyst Resume Examples & Samples
- Defines analysis methodology and provides analytic support to QI staff
- Maintains databases and reports specific to QI functions and regualtory and accreditation requirements
- Collaborates with other teammates to deliver solid, effective solutions
- Provides data for select performance measures to regional offices
- Communicates with external data sources as needed to gather data necessary to measure identified outcomes
- Prepares ad hoc reports as needed for QI management
- Identifies, evaluates and implements new data-driven strategies and processes for the organization
- Develops tools and reports that lend valuable insights that capitalize on a combination of internal and external data
- Recommends enhancements to existing systems in accordance to business needs by creating ad hoc and standard reports as well as new information delivery technologies
- Acts as point of contact for business users providing both tool support and data expertise
- Develops and provides insights into streamlining analytic QI processes
- Assists in the HEDIS data collection process, analyzing trends, and identifying areas of improvement
- Prepares reports and quality improvement studies in an accurate,consise and timely fashion
- Coordinates centralized and market work plans and actions with team members assuring project timeliness and expectations are met
- Manages key project initiatives associated with delegated vendor functions, monitoring and summarizing vendor oversight project progress
- Participates in cross functional internal and external quality teams to improve overall organization performance
- Performs data collection, analysis, reporting and presentation of quality improvement activities
- LI-CW1
28
Quality Improvement Project Manager Resume Examples & Samples
- Recommends methods to improve network provider compliance to health plan QI Program policies and procedures, including profiles/scorecards and efforts to increase provider compliance to practice guidelines, such as through medical record review
- Supports efforts to submit monthly, quarterly, semi-annual, and annual regulatory required performance reports
- Assists in developing short range plans for overall area activities
- LI-JS1
- A Bachelor's Degree in nursing or a related health field or equivalent years of related experience is required
- Required 3+ years of experience in process improvement and project management
- Required knowledge of Medicaid and/or Medicare programs
- Ability to work effectively across departmental lines
- Intermediate or strong skill level with Microsoft Excel, Word, Visio, PowerPoint, and Outlook is required
29
Manager, Quality Improvement Resume Examples & Samples
- Establishes and maintains tracking and monitoring systems for health care quality improvement activities according to regulatory requirements, accreditation standards, policies and procedures and contractual agreements
- Researches and develops performance measurement and outcome studies to assess and improve the health status of the membership. Plans, organizes and manages the design, development and analysis of a wide variety of topics relevant to health care services
- Designs and develops methodologies for preventive care and health care evaluations. Researches and documents current health care standards for use in study design and methodologies. Conducts preventive studies to evaluate the continuity and coordination of care and to assess the quality and utilization of health care services. Provides assistance and guidance to clinical staff with regard to study design, methodology, data analysis and reporting
- Manages and evaluates performance of staff related to clinical and health care services performance improvement activities. Provides department orientation to new staff and ongoing staff development to the entire department
- Coordinates guidelines, studies and performance improvement activities in concert with the utilization management, quality management, pharmacy services, case management and disease management programs
- Prepares, compiles, reviews and submits monthly and quarterly reports for quality committee meetings
- Performs annual update on state Plan Risk Management Program Description
- Completes AHCA Code 15 Reports for confirmed adverse incidents
- Submits an annual AHCA adverse incident summary report
- Presents summary reports of reported AHCA Code 15 adverse incidents through the state Plan quality committee structure and Board of Directors
- Required A Bachelor's Degree in HealthCare, Nursing, Public Health, Health Administration or directly related degree
- Required or equivalent work experience
- Preferred A Master's Degree in Healthcare
- Required 5+ years of experience in directly related Quality Improvement job duties
- Required 1+ year of management experience
- Required Other Excellent knowledge of JCAHO, URAC, AAAHC and NCQA standards
- Preferred Other Experience with Medicaid/Medicare
- Advanced Demonstrated written communication skills
- Advanced Demonstrated analytical skills
- Intermediate Ability to influence internal and external constituents
- Required Other For IL/MO/NJ RN License
- Preferred Licensed Registered Nurse (RN)
30
Medical Director Clinical Documentation & Quality Improvement Resume Examples & Samples
- Drive improved accuracy with front line providers. (Drive change one provider at a time)
- Lead by example; responsible for demonstrating the link between clinical performance and documentation
- Accurately and efficiently conduct medical record reviews with the goal of analyzing clinical data to proactively identify, communicate and lead organizational dialogue related around risk and quality accuracy
- Work closely as a clinical resource with Clinical Documentation Improvement Specialists
- Champion the importance of accurate clinical documentation to improve patient experience and care
- In partnership with CDQI, identify best practices to improve patient outcomes and strengthen performance while driving consistent process/tools across OptumCare
- Implement, manage, and lead integration of clinical chart reviews looking at quality and risk adjustment strategy within OptumCare
- Share the quality/risk adjustment story through development of personal relationships with regional leaders to impact patient care
- Collaborate with market physician champions to develop mentoring programs in risk adjustment
- Promote quality of care developing and using statistical analysis of market performance as it relates to quality and risk adjustment data
- Influence present model processes to identify gaps that would improve clinical activities
- Continue to build on our success and make a notable difference
- Current and unrestricted Medical License in any state
- Board Certification in an ABMS or AOBMS specialty (Primary Care or Hospitalist background preferred)
- 1 or more years in Physician Leadership roles
- 2 or more years in Quality and Risk Adjustment
- Ability and willingness to educate and mentor
31
Quality Improvement Hedis Specialist, RN Resume Examples & Samples
- Monitors and investigates all quality of care concerns and collaborates with medical director to determine impact and next steps for actions. Monitors provider quality complaints to identify trends and educational opportunities for improvement
- Analyzes, updates, and modifies procedures and processes to continually improve QI operations
- Monitors and analyzes outcomes to ensure goals, objectives, outcomes, accreditation and regulatory requirements are met
- Participates in site visit preparation and execution by regulatory and accreditation agencies (State agencies, CMS, AAAHC, URAC, NCQA, EQRO)
- Conducts internal auditing of compliance with regulatory and accreditation standards
- Pursues methods to ensure receipt of data required for trending and reporting of various QI work plan metrics, performs adequate data/barrier analysis, develops improvement recommendations, and deploys actions as approved
- Participates in various QI committees and work groups convened to improve process and/or health outcomes, and contributes meaningful detail, based on functional knowledge. Completes follow-up as assigned
- Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements
- Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline
- Completes Licensed Health Care Risk Management certification program
- Coordinates the regular and systematic review of all potential adverse incidents in accordance with state statute
- Preferred A Bachelor's Degree in Healthcare, Nursing, Health Administration, Public Health or related health field
- Required 3+ years of experience in a clinical acute care, case management, disease management, clinical compliance, public health, home health or clinical nurse position
- Required 2+ years of experience in Managed Care
- Preferred 1+ year of experience in Quality Improvement
- Preferred Other Experience in compliance and accreditation
- Intermediate Demonstrated interpersonal/verbal communication skills
- Advanced Ability to create, review and interpret treatment plans
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Senior Manager, Quality Improvement Resume Examples & Samples
- A Bachelor's Degree in HealthCare, Nursing, Public Health, Health Administration or directly related field required
- Or equivalent work experience required
- A Master's Degree in a related field required
- 7+ years of experience in directly related Quality Improvement job duties required
- 4+ years of experience in Managed Healthcare required
- Other Excellent knowledge of JCAHO, URAC, AAAHC and NCQA standards required
- Other Experience with Medicaid/Medicare required
- Required for FL/IL/MO/CA current unrestricted RN License
- Licensed Registered Nurse (RN), preferred
- Cerified Professionals in Healthcare Quality (CPHQ), preferred
- Intermediate Microsoft Excel Required
- Intermediate Microsoft Word Required
- Intermediate Microsoft Visio Required
- Intermediate Microsoft PowerPoint Required
- Intermediate Microsoft Outlook Required
- Intermediate Healthcare Management Systems (Generic) Required
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Associate Director Quality Improvement Resume Examples & Samples
- Build appropriate interfaces with cross functional departments and participates in cross-departmental best practice working groups for process development / optimization
- Develop seamless partnerships with CSO platform departments and non-CSO platform organizations to ensure CTTs are performing according to necessary ICH/GCP and relevant regulatory requirements and global, departmental and geographical SOPs, policies and guidelines and that the teams are implementing best practices that will help to facilitate the PAI readiness mindset
- Facilitates clinical quality risk identification and the necessary problem solving and corrective measures relevant to PAI readiness and preparation
- Ensure CSO administrative documents, for CSO departments and required for PAI readiness, are maintained, updated and readily available for inspections
- Bachelor degree or higher in a relevant scientific/health-related field
- Minimum of at least 12 years experience in the pharmaceutical industry, with a minimum of 8-10 years experience in clinical and/or quality operations-related roles (e.g., direct study management, monitoring, auditing)
- Experience working within a global team/environment to produce operational reference standards to meet regulatory requirements across regions
- Experienced/certified in Business Process Management (BPM) methodology Experience with FDA or other regulatory inspections of investigator sites, sponsors or CROs
- An extensive knowledge of R&D with past significant experience in clinical operations. In-depth knowledge of SOPs and ICH/GCPs
- Quality focused with a high degree of personal accountability and commitment
- Strong knowledge of international good clinical practices (ICH) and thorough understanding of current regulatory requirements (FDA, EMEA) related/ applicable to the conduct of clinical trials, understanding of FDA Compliance Manual & EMA Compliance Manual Knowledge about requirements of New Drug Application (NDA)/ Market Authorization Application (MAA) submissions and e-submissions Strong knowledge on project management (business and IS projects)
- Demonstrated ability to anticipate problems/ changes impacts, consequences, and delays; work proactively and take the initiative for corrective measures
- Able to provide expert level of guidance to associates on questions related platform QD and processes. Ability to recognize and properly escalate issues that may require higher level management input
- Results driven with attention to detail and quality while overseeing and connecting with contributing stakeholders Strategy focused with ability to extrapolate detail without losing sight of big picture Ability to analyze trends and determine strategic improvement needs Excellent skills to effectively communicate and collaborate with project teams and departmental associates, in all levels of the organization and externally
- Excellent team leadership skills
- Demonstrated skills in taking initiative and working independently
- Strong facilitation skills
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Manager, Quality Improvement Resume Examples & Samples
- Required a Bachelor's Degree in HealthCare, Nursing, Public Health, Health Administration or directly related degree required or equivalent work experience
- Preferred a Master's Degree in Healthcare
- Required excellent knowledge of JCAHO, URAC, AAAHC and NCQA standards
- Preferred experience with Medicaid/Medicare
- Intermediate knowledge of community, state and federal laws and resources
- Advanced demonstrated written communication skills
- Advanced demonstrated interpersonal/verbal communication skills
- Advanced demonstrated analytical skills
- Advanced demonstrated problem solving skills
- Intermediate ability to work in a fast paced environment with changing priorities
- Intermediate ability to multi-task
- Advanced ability to effectively present information and respond to questions from families, members, and providers
- Advanced ability to effectively present information and respond to questions from peers and management
- Intermediate ability to influence internal and external constituents
- Preferred Certified Professionals in Healthcare Quality (CPHQ)
- Required intermediate or stronger skill level with Microsoft Excel, Word, Visio, PowerPoint, Outlook
- Required intermediate Healthcare Management Systems (Generic)
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Director of Clinical Quality Improvement Resume Examples & Samples
- Implements Tenet's Commitment to Quality initiative and assures goals are met
- Ensures hospital compliance with accreditation, licensing and regulatory agenciesRN degree preferred, with experience in quality/performance improvement, and as applicable in case management and other related areas of responsibility OR a Bachelor's degree or higher in a health related field with 5 years of relevant hospital management experience OR other allied health professionals who have at least 7 years of hospital experience in the areas of responsibility
- Ability to interpret and process data in an analytical manner
- Demonstrated understanding of Quality Improvement Organization (QIO) guidelines and required processes
- Demonstrated understanding of current trends in quality and other areas of responsibility as applicable
- Ability to lead and coordinate activities of a diverse group of people
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Director, Clinical Quality Improvement Dcqi Resume Examples & Samples
- Ensures processes are in place to ensure compliance with Quality and Performance Improvement and as applicable with Infection Control, Risk Management, Patient Safety, Peer Review, etc
- Ensures hospital compliance with accreditation, licensing and regulatory agencies
- As applicable, DCQI candidate also has demonstrated knowledge in the areas of Case Management, Utilization Management, Discharge Planning, Social Work, Medical Staff Services, Peer Review, Risk Management, Patient Safety, Infection Control Prevention and Reporting
- Current understanding of regulations as it relates to Joint Commission, State specific requirements, and Centers for Medicare & Medicaid Services (CMS)
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Manager Rn-quality Improvement Resume Examples & Samples
- Responsible for directing and supervising a group of employees involved in inspection and quality control procedures
- Analyze facts or circumstances surrounding individual problems to determine what action should be taken within the limits of standard practices
- Performs internal audits
- Addresses non-conformities from previous internal and external audits
- Prepares and delivers presentations on quality issues
- Educates staff members and licensed independent practitioners on quality indicators
- Following-up on and closing pending Preventive and Corrective Action Requests
- Assists staff in preparing and developing tools in compliance with any regulatory requirements and/or visits
- Must have a minimum of 5 years of Healthcare Quality experience
- Must have a Bachelor’s Degree
- Registered Nurse with current TX license preferred
- Interpersonal skills in order to interact with hospital personnel and physicians
- Computer skills as well as data trending and analysis
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Manager, Continuous Quality Improvement Resume Examples & Samples
- Masters degree required
- Minimum of 3 to 5 years of experience in higher education
- Bilingual in Spanish/English or Portuguese/English required
- Exceptional communication and writing skills
- Demonstrated experience with accreditation preparation and experience in a regulatory environment, preferred
- Ability to work in a highly matrixed organization
- Prior successful remote work experience preferred
- Excellent problem-solving and self-starter skills
- Ability to interface successfully with all levels of management and external stakeholders
- Experience with MS Office applications, Sharepoint
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Regional Director, Quality Improvement Resume Examples & Samples
- Provides regional leadership and expertise in methods of quality improvement
- Supports home office, balanced scorecard and regional goals and targets through collaboration with assigned facility DCQIs
- Provides input for strategic development, planning and implementation of regional and hospital quality plans
- Supports assigned region/hospitals in the formulation of quality related goals and targets
- Ensures hospital based process for compliance with regulatory agencies / authorities and assists the facility in preparation of responses and remediation of quality of care / clinical inquiries from these agencies
- Supports each hospital in the formulation of responses/plans of correction in response to inquiries from surveyors or third party payers
- In collaboration with RCMO, ensures hospital based procedure appropriateness reviews are conducted timely, documented, and referral to peer review is done as warranted
- In collaboration with RCMO, ensures hospital based OPPE, FPPE audits are completed. Ensures and supports hospital completion of operative and invasive audits
- Facilitates, supports, and organizes process improvement and provides staff support services to such teams
- Develops policies and procedures for areas of responsibility
- Provides orientation for new DCQIs and monitors ongoing progress
- Provides input into evaluations for hospital DCQIs in collaboration with RCNE and RCMO
- Collaborates with hospital DCQI supervisor to formulate specific development plans and succession plans
- As applicable, RDCQI candidate also has demonstrated knowledge in the areas of Peer Review, Risk Management, Patient Safety, Infection Control Prevention and Reporting
- Detail oriented and has ability to work with and analyze complex health care process and outcome data using both qualitative and quantitative techniques
- Ability to communicate effectively (written, verbal and presentation skills) with many levels of key stakeholders from the board level to the point of care staff
- Demonstrated understanding of current trends in quality and other areas of responsibility as applicable
- Ability to drive and manage change in the organization to achieve organization strategic initiatives for performance improvement
- Ability to manage multiple projects at one time
- PC based Word and Excel spreadsheet programs
- Industry publications as they relate to Quality and other areas, as applicable, such as Safety, Risk Management, etc
- Hospital specific programs
- Electronic Health Record
- ECARE (Electronic Clinical Analysis and Resource Efficiency)
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Quality Improvement Analyst Resume Examples & Samples
- Work with internal Information Technology and Clinical Analytics departments to build reports on quality and develop new reports based on requests from providers and internal stakeholders
- Work with the clinical areas to develop more automated reports for customer reporting and operational decision making
- Develop knowledge of Pharmacy and all clinical programs in order to support these areas through reporting
- Minimum 2-5 years working in a healthcare setting as the lead or a senior data analyst
- Significant knowledge of and experience with HEDIS data specifications and reporting
- Complete proficiency in Advanced Microsoft – Word, Excel, Access, SQL, PowerPoint
- Master’s degree in a Healthcare, Health Technology or Informatics discipline
- SAS programming skills a plus
- CAHPS
- MS Outlook and Project
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Quality Improvement Skills Training Manager Resume Examples & Samples
- Provide professional advice and guidance on the Wales Deanery’s QIST activity, processes and procedures to internal and external stakeholders, using judgement and creativity to suggest the most appropriate course of action where appropriate, and ensuring complex and conceptual issues are understood
- Ensure the delivery of QIST provision by the Wales Deanery, as required across Wales, proactively changing the delivery according to stakeholder requirements and needs, and ensuring alignment with NHS Wales and Local Education Provider priorities
- Take responsibility for investigating, analysing and resolving issues independently within the Wales Deanery’s QIST provision, supported by advances within quality improvement
- Gather and analyse data to inform decision making, and reporting relating to QIST activity as appropriate
- Plan and deliver projects supporting the Deanery’s QIST objectives, co-ordinating and supervising project teams created as needed
- Develop resources including to support QIST provision by the Wales Deanery
- Establish and build working relationships with internal and external stakeholders, developing appropriate communication links with key contacts as required
- Co-ordinate and support specific working groups as required to achieve the Wales Deanery’s QIST objectives
- Manage the operation of the Wales Deanery’s QIST workstream and team, organising and delegating work, monitoring progress and intervening as required
- Degree/NVQ 4 or equivalent professional membership/experience
- Experience of quality improvement in the healthcare education context
- Ability to demonstrate an understanding of the quality improvement agenda to give advice and guidance to internal and external stakeholders
- Evidence of ability to explore stakeholders’ needs and adapt a service accordingly to ensure high quality provision and advise and influence key stakeholders
- Proven ability to develop networks in order to contribute to long term developments
- Evidence of ability to develop strategy, translate this into operation, and plan the work of a team over extended time periods, reacting to changes to drivers, workload and priorities
- Evidence of experience of undertaking and delivering complex and long term projects, and supervising project teams
- Postgraduate/professional qualification
- Specialist knowledge within quality improvement
- Current driving licence and willingness to travel
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Quality Improvement Project Manager Resume Examples & Samples
- 5+ years of experience working within a Healthcare delivery organization, such as a Managed Care organization or a Hospital environment
- 3+ years of experience in Quality Improvement; 3+ years of experience in Process Improvement and Project Management
- Bachelor's Degree in Nursing or a related Health field
- CT Registered Nurse (RN) license
- Knowledge of Medicaid and/or Medicare programs
- Microsoft Office/Suite proficient (Excel, Word, Visio, PowerPoint, Outlook, etc.)
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VP Operations & Quality Improvement, Ltss Resume Examples & Samples
- Creates, builds and maintains strong relationship with clients establishing trust and creditably of the Optum Brand
- Interacts closely with the State to ensure the success of the Long Term Service Support (LTSS) programs
- Responsible for meeting contractually required deliverables, work
- Assignments, quality and production standards
- Coordinates day-to-day operations to achieve goals and ensures smooth and efficient functioning to meet the contractual requirements
- Partnering with internal and external business partners to identify, recommend and deploy performance improvement opportunities with a high level impact on financial performance and customer satisfaction
- Utilizes multiple tools and methodologies (e.g. Six Sigma, Lean, Value Stream Mapping, Kaizen, Process Optimization, etc.) to analyze data and processes as a key driver of performance opportunities
- Designs and assists in change management activities as part of the execution/implementation of process improvements
- Design Executive Dashboards to illustrate cross-functional improvements and measurement against projects
- Oversight of quality assurance program and audit plan and facilitation of Quality Improvement Committee activities
- Coordinating with EOHHS and the Program Integrity team to identify issues that may involve fraud, waste, or abuse
- Directs multiple teams in a matrix environment and resolve project risks
- Annual travel is 25%
- 10+ years of experience with complex, large scale Programs / Project Management
- Process improvement and/or relevant business experience
- Prior experience leading utilization and / or health management program
- P&L experience
- Managed care or large provider leadership experience
- Proven ability to manage multiple complex projects with cross functional impacts across an organization with high degree of external client management
- Demonstrated ability to communicate complex ideas clearly and concisely and ability to facilitate executive level meeting
- Demonstrated ability to create, build and maintain relationships that enhance performance of the business unit and establishes trust and maintains creditability throughout the organization
- Self-directed, works with minimal guidance, and recognizes when guidance is needed
- Demonstrates decisiveness in resolving business problems, making decisions and Identifying priorities
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Quality Improvement Program Manager Resume Examples & Samples
- Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.*
- Lead cross - functional quality improvement programs
- Ensures projects and programs are completed on time, on budget, and in scope
- Ensures creation and maintenance of program and project - level deliverables including program / project charter, project scope, risk management plan, schedule, communication plan, resource plan, and regular status
- Effectively applies our methodology and enforces program and standards
- Strong facilitation and meeting management skills
- Ability to build and maintain strong internal team relationships and work well in cross - functional teams
- Strong communication skills (written & verbal), with proven ability to effectively communicate to multiple levels of the organization
- Drives complex problem resolution, critically analyzes options, prepares and delivers recommendations, and executes on decisions
- Create presentations to leadership to communicate top quality & continuous process improvement opportunities, along with business partner initiatives to improve quality results
- Serves as a key resource on complex and / or critical issues
- Reviews work performed by others and provides recommendations for improvement
- Lead regular program status meetings with project leads, stakeholders, and steering committee
- Resolves and / or escalates issues in a timely fashion
- Communicates difficult / sensitive information tactfully at all levels across the organization
- Consistently acknowledges and appreciates each team member's contributions
- Motivates team to work together in a manner consistent with our culture
- Mitigates team conflict and communication problems
- Provides leadership to and is accountable for the performance of managers and / or senior level professional staff
- Impact of work is most often at the operational or local business unit or market level
- BA / BS degree in Business or related field and / or equivalent education and experience
- 7+ years experience in tracking and planning complex projects and programs
- Demonstrated ability to drive change, influence individuals at all levels of the organization and to take appropriate risks and consensus building
- Demonstrated ability to communicate ideas clearly and concisely with all levels of the organization
- Demonstrated ability to lead and drive deliverables programs that impact process and technology
- Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
- Experience in healthcare business processes (e.g., Claim Processing, Case Installation, Prior Authorization, Network, Appeals & Grievances)
- Experience implementing new business processes and requirements
- Ability to build strong business relationships
- Strategic thinker; able to consider, support, and deliver against competing priorities
- Strong situational analysis and decision making abilities
- Strong planning and organizational skills with the ability to manage competing priorities
- Intermediate level of proficiency with MS Project, Excel, Word, PowerPoint and SharePoint
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Engine Engineering Quality Improvement Lead Resume Examples & Samples
- Bachelor of Science in Mechanical Engineering, Aeronautical Engineering or Physics
- Minimum of 5 years of experience working with engine engineering
- Design for Six Sigma Green Belt
- Excellent communication skills and problem solving skills
- Experience in root cause analysis
- Ability to work with and lead a cross functional team
- Master of Science degree in Mechanical Engineering, Aeronautical Engineering or Physics
- 10 years engine engineering experience or quality experience
- Design for Six Sigma Black Belt
- Shainan Red X Journeyman
- Shainan Black Belt
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Quality Improvement / Safety Coord Card Surg Resume Examples & Samples
- Accomplishes an on time and seamless project implementation with full Team participation
- Tracks project milestones, identifies problem areas, & coordinates corrective actions. Communicates with service line operations and key stakeholders in all relevant areas of projects and initiatives
- Acts as a resource person for the HLV & SOTP Service Line for the various applications. Abstracts/validates moderate to complex data elements for the UNOS registry and various databases. Enters data and submits in an accurate and timely fashion. Seeks advanced training in project management and quality improvement and safety
- Participates in PI efforts, either within the department or within a larger PI team, related to HLV/SOTP data collection and reporting
- Educates and mentors nursing and ancillary staff in evidence-based practice and new emerging trends
- Handles project team issues through established escalation processes applying resolutions appropriately. Demonstrates ability to act decisively and take effective action in a timely manner
- Serves as a change agent, engaging process teams in a non-confrontational, collaborative, consensus driven approach
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Project Manager FOR Quality Improvement Resume Examples & Samples
- Child Welfare practice, programs, and services
- Child Welfare laws rules and regulations
- Project management techniques
- Strategic planning processes, including the development and monitoring of outcome measures
- Personal computers and various software to include Microsoft Office Suite
- Verbal and written communication
- Establishing and maintaining interpersonal relationships
- Developing and implementing departmental policy
- Conceptualization, design, planning, implementation and monitoring of new programs and practice improvements
- Interpreting and applying Statutory rules and state laws
- Identifying and resolving issues
- Exercising sound judgment when working with internal and external customers
- Write comprehensive correspondence and/or documents
- Learn and adhere to the state legislative process
- Learn and adhere to state and agency policies
- Analyze complex problems and issues
- Facilitate meetings and/or workgroups
- Masters in Social Work or related degree
- 5 or more years of progressive experience as an employee in Arizona’s child welfare system, including experience as a field operations supervisor, manager, or program specialist
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Field Quality Improvement & Field Quality Assurance Specialist Resume Examples & Samples
- Validate responsible department investigation result and lead to proper actions for customer
- Understand field issues correctly, better and frequent communication with dealers to be encouraged. If insufficient information from dealers, proactive and constructive action to be considered
- Understand field action’s importance and necessity by cross regional communication such as Japan, UK, then manage field action progress before and after announcement of our territory of Egypt, Morocco, Algeria and so on
- By internal communication with other department of our function, strong relationship with dealers must be made.LINKEDIN
- Minimum Experience: 2-3 years in automotive industry preferably in dealer communication and product quality
- Has the ability to deal with the goods directly and able to inspect them proficiency
- For the very various different point of views, consider possible root cause and make conclusion
- Cross functional communication skills with supplier/R&D/Plant/Dealer
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Manager, Quality Improvement Resume Examples & Samples
- Review and analyze reports, records and directives
- Confer with staff to obtain data such as new projects, status of work in progress, and problems encountered, required for planning work function activities. Verify data to be submitted in accordance with government program requirements and ensure compliance with state, federal and certification requirements
- Prepare reports and records on work function activities for management
- Oversee the review and analysis of reports
- Evaluate current procedures and practices for accomplishing the assigned work functions objectives to develop and implement improved procedures and practices and to ensure compliance with required standards
- Collaborate with appropriate departments to document, investigate and resolve formal or informal complaints and appeals in accordance with Company and State policies, procedures and requirements
- Monitor and analyze costs and participate in the preparation of the budget
- 3+ years nursing experience and 1 year of recent quality improvement and supervisory experience in a healthcare environment, preferably managed care
- License/Certification:Current state registered nursing license preferred. Certified Professional in Healthcare or other licensed clinical experience preferred
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Quality Improvement Engineer Resume Examples & Samples
- Participates in COS assessments
- Helps develop Functional Excellence Assessments
- Assists with Functional Talent Management processes
- Bachelor’s degree in Engineering or related discipline is required
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Manager, Quality Improvement Resume Examples & Samples
- Researches and develops performance measurement and outcome studies to assess and improve the health status of the membership
- Plans, organizes and manages the design, development and analysis of a wide variety of topics relevant to health care services
- Designs and develops methodologies for preventive care and health care evaluations. Researches and documents current health care standards for use in study design and methodologies
- Conducts preventive studies to evaluate the continuity and coordination of care and to assess the quality and utilization of health care services
- Provides assistance and guidance to clinical staff with regard to study design, methodology, data analysis and reporting
- Manages and evaluates performance of staff related to clinical and health care services performance improvement activities
- Provides department orientation to new staff and ongoing staff development to the entire department
- Bachelor's Degree in HealthCare, Nursing, Public Health, Health Administration or directly related degree or equivalent work experience is required
- Master's Degree in Healthcare is preferred
- 5+ years of experience in directly related Quality Improvement job duties is required
- 3+ years of experience in managed care is required
- 1+ year of management experience is required
- Excellent knowledge of JCAHO, URAC, AAAHC and NCQA standards is required
- Experience with Medicaid/Medicare is preferred
- Knowledge of community, state and federal laws and resources
- Demonstrated interpersonal/verbal communication skills
- Ability to effectively present information and respond to questions from families, members, providers, peers and management
- Ability to influence internal and external constituents
- Licensed Registered Nurse (RN) is preferred
- Certified Professionals in Healthcare Quality (CPHQ) is preferred
- Microsoft Excel is required
- Microsoft Word is required
- Microsoft Outlook is required
- Microsoft PowerPoint is preferred
- Healthcare Management Systems (Generic)
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Director of Clinical Quality Improvement Resume Examples & Samples
- Implements facility’s Commitment to Quality initiative and assures goals are met
- Ability to work with hospital team to motivate relevant constituencies to embrace change as required by facility’s Commitment to Quality and other clinical initiatives
- Ability to work with hospital team to motivate relevant constituencies to embrace change as required by our organization’s Commitment to Quality and other clinical initiatives
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RN Quality Improvement Clinical Lead Resume Examples & Samples
- Perform and/or collaborate with all Market Departments on analysis of trend issues, cost saving opportunities, quality metrics and documentation opportunities
- Serve as focal point for provider groups questions; filter questions to appropriate market source and ensure responses are completed in a timely fashion
- Background in utilization management
- Ability to develop and strengthen networks and relationships, both inside and outside the organization
- Experience leveraging resources to create exceptional outcomes
- Strong organizational and analysis skills
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Quality Improvement Supervisor Resume Examples & Samples
- Minimum of 2 years experience in a hospital setting required
- Master’s Degree preferred, Bachelor’s Degree required
- Clinical health care experience and licensure preferred
- Hospital-based quality, patient safety, regulatory training and experience required
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Senior Quality Improvement Engineer Resume Examples & Samples
- Bachelor’s or Master’s degree in Quality, Biologics, Biotechnology or related area
- More than 7 years of experience in an improvement role in the pharmaceutical industry
- Experience with cGMP and knowledge of Lean Six Sigma tools (Black Belt Level)
- Knowledge of and experience with quality and compliance guidelines and manufacturing processes
- Knowledge of regulations in Production, Validation, Quality Assurance/ Control, Quality Systems (Investigations, Change Controls, etc.)
- Ability to convert quality mindset into practice and to bring others on that same page
- Strong focus on clients and change management skills
- Ability to work under minimum supervision and team work oriented
- Computer literacy knowledge and statistical knowledge
- Strong oral and written communication skills in both Dutch and English
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Quality Improvement Lead Saint Francis Hospital Memphis Resume Examples & Samples
- Oversees education for practices on care standards and efficient workflows
- Oversees Gap Analysis for each practice and reports those findings to the local practice champion(s)
- Assists local practice champions in compiling information for, and completing, National Committee for Quality Assurance's Patient Centered Medical Home/Patient Centered Specialty Practice applications
- Assists member practices with Physician Quality Reporting System submission, Meaningful Use attestation, and Medicaid quality reporting
- Successfully develops and maintains relationships with member practices and Practice Transformation Network core team to ensure timely and supportive communication is shared with all stakeholders
- Monitors data associated with assigned practices and addresses any performance issues
- Oversees process redesign and workflow improvement
- Work experience may substitute for minimum education requirement.**
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Quality Improvement Clinical Manager Resume Examples & Samples
- Achieve performance metrics for a fast paced clinical environment
- Develop team members and creating department process flows
- Provide strategic guidance toward process improvements
- Experience identifying quality indicators and integrating process improvements
- Progressive experience in quality improvement (HEDIS, Stars or Care management) with emphasis with leading and managing teams
- BSN or advanced degree
- Medicare
- Care Management
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Resuscitation Quality Improvement Sales & Implementation Resume Examples & Samples
- Share targeted sales goals with our Regional Directors (based on subscription implementations) that align with the overall vision of the program
- Perform an assessment on each individual international county’s RQI needs and map that against available products, features and offerings. Recommend to Leadership market priorities and once set, liaise with international development teams on needs including translation priorities
- Working with each of our Regional Directors, International staff and volunteers on developing sales programs and strategies for International RQI. Each opportunity must include a thorough understanding around the culture, funding opportunities, product availability, relationship with our Sister Societies, political environment, government interactions, key stakeholders, etc. to ensure the sales process is appropriate and effective
- Develop standardized sales manuals and procedures for AHA initiated sales. Streamline the Site Survey process and related downstream workflows to ensure an effective sales process and timely product offering. Ensure an adequate sales funnel process exists with our internal resources and alliance team to ensure resources are available when needed
- Develop best in class implementation guidance and assistance to minimize the time between the completion of the sales contracting process and the go live date of RQI with each customer and ensure ongoing customer satisfaction and integration
- Develop best practices for RQI Programs for the successful management of adoptions by working with AHA Staff, Laerdal, and International Marketing. Support the training of AHA staff on best practices, hold RQI administrator’s summits covering. implementation guidance and sustainability tools. Ensure that Regional Directors and International Marketing are highly aligned on individual market needs, marketing tools, communications, etc
- Develop the appropriate implementation of solutions that are focused on exceeding client expectations and delivering learning solutions, driving revenue opportunities. Manage solution success to ensure program growth and sustainment. Integrate the sustainment of success management with adoption, and account penetration, and long-term engagement of customers, stakeholders and their staff. Collaborate with International Marketing to develop tools and communications for these activities
- Work with Global Operations, Legal and Finance on ensuring a well-defined process exists with regard to contract management. This includes ensuring that country relevant Master Service Level agreements are in place, change orders are appropriately managed, timely invoicing and accounts receivable are being managed. In addition, work with Laerdal on proper settlement of RQI royalties
- Work with ECC and Laerdal IT, and AHA BT to ensure that the systems needs to support RQI are developed (including translations) and appropriately integrated. This includes interfaces with customer LMS, CDP, CRM, CPR Verify, etc
- Ensure issues are addressed quickly and effectively, leveraging the integration of opportunities and training and provide assistance on other projects as assigned by staff leadership
- Cultivate and strengthen key customer relationships which impact program goals with hospitals, health care systems and EMS agencies. Coordinate activities with RQI and International Leadership, International Field Staff, National Center staff, Laerdal staff and our International Sister Societies as needed
- At least five (5) years of relevant experience
- Demonstrated experience with healthcare solution-based sales, supporting sales acumen in colleagues and implementation of large scale systems
- Proven experience in building and managing relationships with C-Suite, external alliances and implementations of large, complex solutions
- Knowledge/experience with emergency or critical care medicine delivery and/or training
- Prior International business experience and cultural competencies with demonstrated success
- Ability to educate and influence various stakeholders on all aspects of RQI (financial benefit, technology, skill maintenance, quality of care, etc.)
- Highly proficient in the Microsoft Office Suite of products
- Master’s Degree
- Bi-lingual Skills
- Ability to travel up to 65% - 75% local and overnight stay with some international travel
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Quality Improvement Analyst Resume Examples & Samples
- Ability to effectively communicate in English, both verbally and in writing
- Ability to convey goals and objectives clearly and in a compelling manner listen effectively and clarify as needed confirm all verbal messaging via written document produce clear status reports communicate tactfully and candidly
- Confidence in decision-making
- Strong analytical ability, excellent communication skills, with the ability to manage projects and multiple priorities at the same time. Able to work under strict deadlines
- Self-motivated and able to provide results with minimal supervision
- Experience in working with data, understand data structures/relationships, and data reporting
- Experience in Quality Improvement processes, methodologies, and QI project management
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Project Manager Quality Improvement Initiative Resume Examples & Samples
- Lead the project team, establish the project execution approach and oversee project hand-over, execution planning, and monitoring and control activities for both internal and external resources to accomplish all project goals
- Focus on reducing the number of quality cases and ensure that quality issues are tackled by the root cause
- Ensure sufficient staffing of the project
- Ensure that the project scope is broadly accepted in the whole organization and that the project delivers measurable results
- Align activities with related quality improvement projects on BU level, in R&D and SCM
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Healthcare Quality Improvement Resume Examples & Samples
- Drive organizational alignment, awareness and accountability to achieve a 4 Star overall performance for Silverscript and Medicare Clients achieving 4+ Stars for select Star Ratings measures
- Lead and continuously refine the business processes that provide oversight and management of the Stars Initiative Budget (~$14M) to ensure investments generate maximum impact on Stars performance and to maintain actual spend within 5% of approved forecast and budget
- Lead and continuously refine the business processes that provide oversight and management of ~$3M financial risk associated with Stars Performance Guarantees
- Provides insights from analyses to drive results, as well as develop best-in-class tools to project, monitor and forecast Stars performance
- Win new clients and grow services with existing clients by differentiating CVS Health ability to support their quality goals
- Evaluate and communicate impacts of CMS policy changes; work with business partners to execute necessary program and reporting updates
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Quality Improvement Business Analyst Resume Examples & Samples
- Analyzes key metrics, such as top diagnoses, clinical procedures, and operational performance, to enable the development of sound and valid recommendations regarding and prioritization of clinical and service improvement initiatives
- Assists in activities to prioritize clinical and service improvement initiatives
- Monitors and tracks market progress on market specific activities and conducts the appropriate follow up as needed to ensure status updates are complete and accurate
- Manages activities that cross multiple markets and departments for improvement in quality outcomes
- Required 2+ years of experience in Quality Improvement or Business Analysis
- Required 3+ years of experience in a Healthcare delivery organization, such as managed care or hospital environment
- Intermediate Ability to multi-task
- Intermediate Demonstrated time management and priority setting skills Ability to remain calm under pressure
- Intermediate Ability to implement process improvements Ability to work overtime as required
- Preferred Licensed Practical Nurse (LPN)
- Required Intermediate Microsoft Excel
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Registered Nurse Continuous Quality Improvement Resume Examples & Samples
- Supporting the organization-wide, integrated framework for quality, safety, and value as defined in VHA Directive 1006, VHA Enterprise Framework for Quality, Safety, and Value
- Develops and maintains improvements and foster and organization-wide culture of integrity and accountability that is vigilant and mindful; proactively risk aware, highly reliable, predictable, and seeks to continuously improve
- Supporting a comprehensive, organized, continuous readiness program to review and identify opportunities for improvement in order to achieve excellence in the quality and safety of care, treatment, and services provided to patients
- Reviews all performance improvement data for assigned areas and assists responsible staff in initiating/facilitating appropriate action based on VA guidance
- Provides clinical expertise and consultation to assist in data driven decision making and performance improvement matters
- Conducts regular training sessions for employees to learn improvement strategies and tools and engage in improvement activities
- Guides team members in mapping and flow processes
- Develop policy guidance, motivational materials, and information to facilitate staff compliance with required implementation of changes
- Maintains data components and records associated in each Improvement team, which include the tracking and trending of data, aggregating into reports, ensuring compliance with established timeframes, and facilitating improvement action plans
- VA Form 10-2850a - Application for Nurses and Nurse Anesthetists (Available http://www.va.gov/vaforms/medical/pdf/vha-10-2850a-fill.pdf). This is a required form and must be submitted. Applicants who fail to submit will be rated ineligible for consideration. Additionally, applicants who fail to provide a complete and detailed explanation in response to any question (28-37) in which your answer is "Yes" will also be rated ineligible for consideration. This response should be provided on a separate sheet of paper as instructed on the form
- OF-306 - Declaration for Federal Employment (Available at http://www.opm.gov/Forms/pdf_fill/of0306.pdf). Applicants who are not current federal employees will be rated ineligible if this form is not submitted. Additionally, applicants who fail to provide a complete and detailed explanation in response to any question (9-15) in which your answer is "Yes" will also be rated ineligible for consideration. Please note: the OF-306 with a revision date of October 2011 is the only acceptable version. Previous editions are obsolete and unusable. You will be rated ineligible if the incorrect version is submitted
- If prior military service, include all copies of your DD Forms 214. Applicants claiming preference based on service-connected disability, or based on being the spouse or mother of a disabled or deceased Veteran, must also complete and submit an SF 15, Application for 10-Point Veteran Preference (available at http://www.opm.gov/forms/pdf_fill/SF15.pdf)
- If currently employed in the Federal system, include latest SF-50 - Notification of Personnel Action
- Copy of licensure
- Copy of transcripts (unofficial are sufficient but must document degree was awarded)
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Mgr, Quality Improvement Compliance Resume Examples & Samples
- Collaborates to ensure accountability for timely and accurate completion of State-mandated QI activities
- Surfaces and escalates discrepancies where Health Plan policies and procedures differ materially from standard Corporate responsibilities or ensures that any differences have a sound business justification
- Surfaces and escalates any gaps in processes that may result in gaps in member care or satisfaction
- Works to ensure all QI compliance related activities are successfully accomplished each year, including: NCQA Accreditation, CMS Part C and D Data Validation, SNP Structure and Process, SNP Model of Care, or other activities as required
- Develops training and coaching materials and provides training sessions to staff and other stakeholders as needed
- 5+ years experience in managed healthcare, including at least 2 years in health plan quality improvement or equivalent/related experience
- NCQA Accreditation experience
- State QI experience
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Regional AVP, Quality Improvement Resume Examples & Samples
- Works with senior executives, Vice Presidents and others across Molina Healthcare (within Molina Plans and within various corporate departments) to set and achieve quality goals
- Develops training, goals and coaching plans for Quality staff
- Ensures that quality assurance is performed for all reports generated by staff reporting to this position. Examples include reports for Senior Leadership Teams, performance measurement tracking, and medical record review completion status
- Escalates gaps and barriers in implementation and compliance to VP, Quality and other corporate senior management as appropriate
- Serves as a subject matter expert and represents the QI department in meetings and discussions about functional area
- Collaborates and facilitates activities with other units at corporate and Molina Plans
- Identifies new QI requirements and builds out processes in advance of effective dates
- Minimum of 10 years relevant experience, including at least 5 years in health plan quality improvement
- 4 years Medicaid/ Medicare experience
- Minimum 3 years people management experience
- Demonstrated knowledge of and experience with HEDIS programs
- NCQA Accreditation experience
- Technical experience in reporting and/or programming
- Proficiency with Excel and Visio (flow chart equivalent) and demonstrated ability to learn new information systems and software programs
- CAHPS improvement experience
- STARS improvement experience
- State QI experience
- 3+ years experience in Reporting & Analytics
- 3+ years health care information systems experience
- Knowledge of HOS, pay for performance, basic experience with other quality metrics like PQI (hospital), NQF-sanctioned measurement
- Experience with clinical intervention concepts, design of quality improvement projects (QIPs), advanced QI concepts, identification of target and subset populations, and basic statistical analysis and significance concepts
- Provider credentialing; PQOC review
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AVP, Health Plan Quality Improvement Resume Examples & Samples
- Works within the health plan and collaborates with corporate QI to set and achieve quality goals
- Sets training, goals and coaching plans for Quality staff
- Ensures that quality assurance is performed for all reports generated by staff reporting to this position, including reports for Senior Leadership Teams and State Health Plan Board of Directors
- Escalates gaps and barriers in implementation and compliance to corporate QI and health plan senior management
- Serves as a subject matter expert and represents the QI department in meetings and discussions about functional area
- Identifies new QI requirements and builds out processes in advance of effective dates
- Minimum of 10 years relevant experience, including at least 5 years in health plan quality improvement
- 4 years Medicaid/ Medicare experience
- Minimum 3 years people management experience
- Demonstrated knowledge of and experience with HEDIS programs
- NCQA Accreditation experience
- Technical experience in reporting and/or programming
- CAHPS improvement experience
- STARS improvement experience
- State QI experience
- 3+ years experience in Reporting & Analytics
- 3+ years health care information systems experience
- Knowledge of HOS, pay for performance, basic experience with other quality metrics like PQI (hospital), NQF-sanctioned measurement
- Experience with clinical intervention concepts, design of quality improvement projects (QIPs), advanced QI concepts, identification of target and subset populations, and basic statistical analysis and significance concepts
- Provider credentialing; PQOC review
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Senior Specialist, Quality Improvement Resume Examples & Samples
- Min. 3 years experience in healthcare with minimum 2 years experience in health plan quality improvement, managed care or equivalent experience
- 2 years coding and medical record abstraction experience
- 1 year managed care experience
- Basic knowledge of HEDIS and NCQA
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Program Director, Quality Improvement Resume Examples & Samples
- Serves as a QI subject matter expert and leads programs to meet critical Quality needs
- Manages QI programs with oversight from the Director, AVP and VP as needed
- Collaborates and facilitates activities with other units at Corporate and within Molina State Plans
- Provides direction for QI program activities with department leadership including leading Corporate quality initiatives that require timely follow-up, tracking and communication on an on-going basis
- Communicates with and escalates gaps and barriers in implementation and compliance to department leadership, including proposed resolution
- Monitors and tracks key quality indicators, programs and initiatives to reflect the value and effectiveness of the quality program
- Develops and ensures that automated reporting and interventions tools are implemented effectively (through development, training and roll out)
- Collaborates with Molina State Plans to identify areas and strategies for improved reporting and use of reporting tools
- Leads key Clinical Intervention activities including implemention of national and state-based Quality interventions, meeting state and federal intervention rules and aligned with best practices identified in literature and within Molina plans
- Works with Molina Plans and QI leadership to ensure that interventions are communicated, monitored and reported on a timely basis to demonstrate program effectiveness
- Facilitates and builds high quality clinical care/services through relationships with key departments within Molina and at Molina plans
- Leads HEDIS Performance Measurement programs using knowledge, skills and technical expertise in performance measurement, data collection and reporting
- Maintains confidentiality and complies with the Health Insurance Portability and Accountability Act (HIPAA)
- Minimum of 7+ years relevant experience, including at least 5 years in health plan quality improvement
- Demonstrated knowledge of and experience with HEDIS programs
- 2 years Medicaid experience
- 2 years Medicare experience
- 3 years management experience
- Operational knowledge and experience with Excel and Visio (flow chart equivalent)
- Proficiency with data manipulation and interpretation
- NCQA Accreditation experience
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AVP, Quality Improvement Resume Examples & Samples
- Works with senior executives, Vice Presidents and others across Molina Healthcare (within Molina Plans and within various corporate departments) to set and achieve quality goals
- Develops training, goals and coaching plans for Quality staff
- Ensures that quality assurance is performed for all reports generated by staff reporting to this position. Examples include reports for Senior Leadership Teams, performance measurement tracking, and medical record review completion status
- Escalates gaps and barriers in implementation and compliance to VP, Quality and other corporate senior management as appropriate
- Serves as a subject matter expert and represents the QI department in meetings and discussions about functional area
- Collaborates and facilitates activities with other units at corporate and Molina Plans
- Identifies new QI requirements and builds out processes in advance of effective dates
- Minimum of 10 years relevant experience, including at least 5 years in health plan quality improvement
- 4 years Medicaid/ Medicare experience
- Minimum 3 years people management experience
- Demonstrated knowledge of and experience with HEDIS programs
- NCQA Accreditation experience
- Technical experience in reporting and/or programming
- Proficiency with Excel and Visio (flow chart equivalent) and demonstrated ability to learn new information systems and software programs
- CAHPS improvement experience
- STARS improvement experience
- State QI experience
- 3+ years experience in Reporting & Analytics
- 3+ years health care information systems experience
- Knowledge of HOS, pay for performance, basic experience with other quality metrics like PQI (hospital), NQF-sanctioned measurement
- Experience with clinical intervention concepts, design of quality improvement projects (QIPs), advanced QI concepts, identification of target and subset populations, and basic statistical analysis and significance concepts
- Provider credentialing; PQOC review
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Manager, Quality Improvement Compliance Resume Examples & Samples
- Manages Quality Improvement Compliance activities and staff, including developing work plans to meet NCQA and state and federal-based quality improvement compliance requirements. Ensures Molina plan(s) maintain NCQA Accreditation and, at the corporate level, brings new or acquired plans to NCQA Accredited status
- Prepares readiness timelines and facilitates work within corporate and state plan departments to complete projects
- Maintains library of accreditation and regulatory updates from NCQA, CMS and state regulators
- Operational knowledge and experience with Excel and Visio (flow chart equivalent)
- HEDIS reporting or collection
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Quality Improvement Officer Resume Examples & Samples
- Knowledge of API manufacturing
- Knowledge of equipment and procedures used in API Manufacturing and ability to understand new technology/equipment
- Knowledge of operational aspects of API manufacturing activities
- Significant knowledge and experience in quality and compliance, preferably API manufacture
- Knowledge of QMS, Company Systems and Regulatory expectations
- Sound knowledge and understanding of appropriate standards and procedures with regards to Quality, GMP, Validation, Safety, Environment and Engineering
- Computer literate and competent in the use of desktop office products, as well as, other Company business systems
- Knowledge of lab-based systems
- Knowledge of the GSK Production System
- Experience within primary and/or secondary pharmaceutical manufacture
- Ability to perform root cause analysis
- Previous project management / coordinator experience
- Membership of a professional body (e.g. RSC, IOB)
- OE Greenbelt accredited
- To ensure site activities associated with the Quality Improvement Plan are in compliance with GSK quality management system requirements, including relevant GMP requirements (e.g. EU GMP, US GMP, Japanese GMP)
- To participate in all aspects of improvement activities for the site, as directed by the Site Quality Improvement Leader
- Ensure effective interaction with central Quality functions
- Actively manage and ensure delivery of key initiatives supporting delivery of the sites Quality Improvement Plan
- Support implementation of a Gemba with Purpose approach to review high risk processing activities and deliver improvements
- To embed GPS in the management and delivery of the Quality Improvement Plan
- Support the Site Quality Improvement Leader in delivering a cultural change at site focusing on mindsets and behaviours and embed best practices
- Where required, to support teams in Root Cause Analysis
- To deliver training related to the Quality Improvement Plan to site based teams (e.g. eDM, Human Factors, DI awareness)
- To support day-to-day activities associated with maintaining QMS compliance, particularly in the area of Quality Improvements for the GSK site
- To manage daily activities with a positive and proactive “zero overdue” culture
- To coordinate and chair Quality Improvement meetings
- Maintain the Quality Improvement GPS Performance Boards
- Participate in the Quality Improvement communication and engagement plan
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Quality Improvement, Project Manager, Senior Resume Examples & Samples
- Establishes and/or revises existing WellCare policies and procedures necessary for successful implementation of the Quality Improvement (QI) Program
- Acts as knowledge expert for continuous quality improvement activities, educating staff of other functional areas regarding the QI process and accreditation requirements
- Fields annual member and provider satisfaction surveys, working with vendor to clarify results and present findings and recommendations to senior leadership
- Assists with efforts to secure successful NCQA accreditation
- Participate in site visit preparation and execution by various regulatory and accreditation agencies (DCH, DHR, CMS, EQRO)
- Develops and oversees the implementation of programs and strategies
- Technical Skills/Requirements: Proficient in Microsoft Office such as Excel, Word, Visio, PowerPoint and Outlook
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Quality Improvement Care Coordinator Resume Examples & Samples
- Telephonic scheduling of general tests for patients
- Retrieve patient history via EMR Software
- Speak with patients about treatments and provide clinical and clerical support to the nurses in the department
- Documents and report findings and observations, handles inquiries and correspondence
- Minimum: Working knowledge of basic Medical Assistant principles and practices
- Minimum: Medical equipment and maintenance knowledge
- Preferred: Experience with multi-tasking, organizing,setting priorities, and meet deadlines
- Preferred: Experience with HIPAA regulations
- Preferred: Results and goal-oriented with a philosophy for quality improvement
- Possess high degree of accuracy, efficiency, and dependability
- Ability to perform multiple tasks and possess strong organization skills
- Ability to follow written and oral instructions and to work with general guidance
- Ability to master different medical record software programs
- Demonstrated proficiency and advanced understanding of Microsoft Office, Email and general computer functions
- Local travel may be required
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Quality Improvement, Project Manager Senior Resume Examples & Samples
- Works with QI Director to convene various QI committees and work groups, set agenda to drive desired meeting outcomes (based on contract and accreditation requirements), and ensure proper recording of committee activities
- Monitors and tracks all state and federal quality improvement and reporting requirements
- Acts in liaison capacity with other areas and business units
- Makes recommendations on matters of policy in area of expertise
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Quality & Improvement Engineer Resume Examples & Samples
- Act as the Quality interface between Rolls-Royce Defence Aerospace and the operational customer at the bases covered. Flow key Quality Issues / Escapes / Metrics to the relevant Programme Quality Engineer's based at Rolls-Royce Defence Aerospace Bristol
- Provide support to Business Plan / Quality Plan deployment
- Provide guidance on the application of Rolls-Royce Management System (RRMS)
- Provide coaching and guidance on use of quality tools and techniques
- Set up and operate daily / weekly / monthly compliance checks
- Provide advice and approval of local yellow belt projects
- Attend Continuing Airworthiness Management Organisation meetings as required by bases and contracts supported
- Work in conjunction with Defence Quality Assurance Field Force and Fast Air Support Team - Quality Assurance, attending meetings and processing Quality Occurrence Reports
- Represent the company at customer initiated quality meetings for other engine platforms should the need arise
- When delegated by the Operations Manager provide cover for absent team members
- Work with other deployed Quality and Improvement Engineers when required
- Prepare and run the UK Deployed Operations Quality Board with input from bases supported and other Deployed Quality and Improvement Engineer's
- Degree or equivalent experience (apprenticeship or Military Training) in an appropriate discipline
- Chartered Membership of an appropriate Institute such as the Chartered Quality Institute (CQI) or Chartered Engineer
- Problem solving experience utilising the 8D process
- Green Belt trained - Black Belt desirable
- Be an approved Lead Auditor to AS 9100 / 9110 with experience of MRP 145 deployment
- Experience of having lead Improvement projects that deliver tangible benefits
- You will be expected to travel regularly to the Bristol site to liaise with the Quality Function Team, Operations, Engineering and Programme Teams
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Manager, Quality Improvement Resume Examples & Samples
- Manage and oversee the BlueCare Tennessee QI Program Goals and Objectives
- Manage and promote an organization wide understanding of the BlueCare Tennessee Quality Improvement Program
- Align and collaborate with enterprise wide quality initiatives, seeking efficiencies and best practice
- Manage QI reporting including analyzing validity of Quality Improvement data/reports from a clinical perspective
- Manage the development, implementation, and evaluation of Quality improvement action plans for clinical quality improvement activities
- Manage the analysis and action planning related to the member/provider satisfaction survey process
- Manage the development and realization of HEDIS, CAHPS action plans to achieve target improvement goals
- Supports the health plans’ external audit processes
- Provides oversight for the BlueCare Tennessee Quality Improvement Committee Structure
- Contributes to new business activities (RFP responses, new program development, and employer group and government marketplace/exchange contract changes etc.) related to quality improvement
- Supports National Committee for Quality Assurance (NCQA) standards, or other regulatory bodies such as External Quality Review Organization (EQRO)
- Assures compliance with State and Federal quality improvement/assurance requirements
- Collaborates with BlueCare Tennessee and BCBST Leadership Team and External Communication leaders to meet the QI information needs of customers
- Develops the annual operating budget to sufficiently meet departmental needs and ensures that the department stays within budget and accounts for variances
- Responsible for hiring and managing staff
- 5 years of clinical experience required
- Minimum 4 years of relevant Managed Care or Quality Improvement experience required
- 5 years management responsibilities required
- Demonstrated ability to develop and lead effective teams with experience managing large scale divisional change
- Experience with medical support systems and project management highly preferred
- Experience with NCQA and HEDIS Guidelines and Accreditation
- Experience with commercial population highly preferred
- Excellent communication and presentation skills, both verbal and written are essential. This includes the ability to successfully work with both clinical and non-clinical personnel
- Demonstrated ability to develop and lead effective teams with experience managing large scale organizational change
- Ability to develop and give presentations and to assume the role of facilitator
- Appreciation of cultural diversity and sensitivity towards target population
- Certified Professional in Healthcare Quality (CPHQ) preferred
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Quality Improvement Project Specialist Resume Examples & Samples
- Provide support to multidisciplinary teams in the development, implementation and evaluation of quality care initiatives
- Serve as a resource to multidisciplinary team assisting data analysis efforts in order to identify opportunities to improve patient care
- Work actively with clinical staff to facilitate the highest possible performance on selected clinical quality measures
- Participate in the development and implementation of strategies to enhance continuous improvement in process and outcomes
- Educate clinical staff, students, residents, and faculty regarding national clinical quality measures and the department’s performance on these measures
- Educate clinical staff, students, residents, and faculty regarding opportunities to improve selected aspects of clinical care and the specific actions needed in order to achieve institutional goals for improvement on selected clinical quality measures
- Develop and maintain positive, collaborative, supportive working relationships with the medical staff, nurses, administration, department management and staff
- Participate in the development and implementation of data collection tools
- Ensure accurate collection of data for selected, standardized measures of clinical quality
- Review accuracy of data collected from clinical records and other sources
- Provide pertinent Core Measure, other quality data and related improvement reports in a timely manner to QI leadership, relevant QI teams, nursing units and clinical departments
- Plan, organize, and prioritize work in order to meet organizational goals and objectives
- Provide education and support to colleagues and staff regarding quality improvement
- Actively network internally and externally to develop skills, knowledge base, and opportunities to promote the quality initiatives at BMC. Participate in pertinent professional education to maintain current knowledge of best improvement practices for select patient populations
- Utilizes hospital’s cultural beliefs as the basis for decision making and to support the hospital’s mission and goals
- Participate on other improvement projects as assigned
- 5 years of experience in quality improvement or process improvement in a hospital or comparable environment
- Strong computer skills including Microsoft Office platform—Word, Access, Excel, PowerPoint, Flowcharting/mapping (QI Charts), E-mail, Web/Internet
- Ability to learn and effectively use computer software, such as electronic health records and data entry tools
- Demonstrated skill and effectiveness in clinical quality improvement strongly preferred
- Strong interpersonal skills; ability to establish supportive, collegial relationships
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Quality Improvement Project Specialist Nurse Resume Examples & Samples
- Provide support to multidisciplinary teams in the development, implementation and evaluation of quality care initiatives for specific patient populations
- Participate in the development and implementation of data collection tools
- Ensure accurate collection of data for selected, standardized measures of clinical quality
- Review accuracy of data collected from clinical records and other sources
- Enter data retrieved from clinical and administrative systems into web-based programs
- Work effectively with colleagues internally and externally to ensure that deadlines are met for data submission to various internal and external stakeholders
- Provide pertinent Core Measure, other quality data and related improvement reports in a timely manner to QI leadership, relevant QI teams, nursing units and clinical departments
- Serve as a resource to multidisciplinary team assisting data analysis efforts in order to identify opportunities to improve patient care for selected patient populations
- Work actively with clinical staff to facilitate the highest possible performance on selected clinical quality measures
- Participate in the development and implementation of strategies to enhance continuous improvement in process and outcomes of assigned population(s)
- Educate clinical staff, students, residents, and faculty regarding national clinical quality measures and BMC’s performance on these measures
- Educate clinical staff, students, residents, and faculty regarding opportunities to improve selected aspects of clinical care
- 2 or more years experience in clinical quality improvement strongly preferred
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Quality Improvement Data Analyst Resume Examples & Samples
- Advanced proficiency use of desktop productivity tools including Excel, Word, PowerPoint
- Demonstrated ability to use ACCESS, SQL or similar analytic tools
- Ability to organize, synthesize and analyze large amounts of information
- Ability to manage multiple projects and deliver required products in a timely manner
- Must be well-organized
- Detail oriented with a commitment to producing analytic product that consistently meets the highest standards of accuracy
- Ability to understand and meet the information needs of clinical and administrative customers
- Excellent interpersonal skills and the demonstrated ability to work in a team oriented environment
- Strong verbal and written skills. Must be able to communicate effectively with diverse audiences including physicians, nurses, allied health professionals, administrator and a wide-variety of non-technical staff
- Ability to explain data analysis to non-technical audiences
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Quality Improvement Analyst Resume Examples & Samples
- Support the Director of Quality Improvement in initiatives to improve overall BHPL operations, licensure and enforcement activities
- Coordinate, implement and track completion of strategic planning goals and initiatives
- Liaise with Directors and BHPL staff to collect and organize time sensitive information, data, and strategic planning projects as necessary
- Draft and prepare BHPL reports and ensure timelines are met, including but not limited to: the Quality in Health Professions Trust Fund Annual Report and the Board of Registration in Pharmacy Investigations and Disciplinary Report, and the BHPL Annual Report, including the compilation of information from all Board Executive Directors, audits of internal systems, and data for charts and graphs
- Draft, edit, and standardize policies for BHPL, including the Drug Control Program, the Office of Public Protection ,and the ten Boards of Registration and Certification
- Oversee and coordinate the web liaison program for BHPL, including but not limited to posting time sensitive alerts and important public Board materials
- Assist in BHPL website development including recommendations for uniformity and consistency throughout BHPL pages
- Develop and track the progress of BHPL staff training plans and assess future needs of BHPL for additional training
- Compile information for statistical reporting on complaints, enforcement, and licensing; collect, run and analyze other Board information such as CORI reports and Continuing Education Unit audits
- Preferred candidate will have experience in the following areas with a minimum of three years combined experience: regulatory compliance and enforcement; licensure and regulation; regulatory board(s) activities and administrative operations
- Strong written and oral communication skills, including methods of general report writing and proficiency in Microsoft Office applications including Excel, Word, Outlook, Visio
- Knowledge of the methods used in the preparation of charts, graphs, and tables, and ability to prepare these items
- Ability to understand, explain, and apply the laws, rules, regulations, policies, procedures, specifications, standards, and guidelines governing assigned activities
- Ability to analyze and determine the applicability of data to draw conclusions and make appropriate recommendations
- Ability to gather information through questioning individuals and by examining records and documents
- Ability to maintain accurate records
- Ability to write concisely, to express thoughts clearly, and to develop ideas in a logical sequence
- Ability to give and follow written and oral instructions
- Ability to adjust to changing or varying work situations to meet emergency or changing program requirements
- Ability to motivate others and coordinate the efforts of others in accomplishing assigned work objectives
- Ability to exercise discretion in handling confidential information
- Ability to supervise, including planning and assigning work according to the nature of the job to be accomplished, the capabilities of subordinates and available resources; controlling work through periodic reviews and/or evaluations; determining subordinates’ training needs and providing or arranging for such training; motivating subordinates to work effectively; determining the need for disciplinary action and either recommending or initiating disciplinary action
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Quality Improvement Project Manager Resume Examples & Samples
- Bachelors of Arts (BA) / Bachelors of Science (BS) degree
- Experience in project management, program evaluation, team facilitation, data analysis, and/or medical management
- 3 years of experience in project coordination/management
- 1 year of quality management/quality improvement experience
- Graduate degree in public health, public administration or clinically related field
- Health insurance industry experience
- Experience with RFPs (request for proposals)
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Manager, Quality Improvement Resume Examples & Samples
- Coordinate regulatory quality initiative activities on an ongoing basis
- Develop and implement methodologies for data collection
- Develop and monitor Quality Management budget
- Maintain an understanding of current quality and utilization applications
- Maintain internal contacts with various ancillary departments, directors, case managers, information services staff and physicians to support data analysis/management in order to affect appropriate service, planning, design, implementation and ongoing re-evaluations
- Manage and coordinate facility, system and regulatory quality initiatives
- Monitor outcomes data and communicate findings to decision-making groups
- Oversee responsibilities of Quality department
- Provide user groups with specific profile targeted to demonstrate the individual practice patterns for comparative benchmarking and applicable planning
- Supervise quality staff in the Care Management/Quality Department
- Masters degree in nursing required
- 5 years experience in, data collection/analysis, presentation, research interpretation and assessment, coordination of implementation plans in a health care environment required
- Minimum 3 years acute care experience preferred
- Previous experience in quality and process improvement strongly preferred
- Previous management/leadership experience strongly preferred
- Knowledge of Medicare programs strongly preferred
- Previous nursing experience in a hospital setting strongly preferred
- Excellent computer skills. Knowledge of Microsoft Office (Access, Word, Excel and PowerPoint)
- Demonstrated proficiency using complex computer applications
- Information service technology experience preferred
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Coordinator, Quality Improvement Resume Examples & Samples
- Adhere to the UPMC Health Plan HIPAA Compliance Guidelines. Ensure that HIPAA standards are met in all aspects of the Department functions including delegated functions. Ensure that all releases of member personal health information, which are conducted outside of the realm of Treatment, Payment, or Operations are appropriately documented
- Assist with the coordinated responses to Requests for Information or Proposals for the UPMC Health Plan Business Development staff related to the Quality Improvement program
- Assume accountability for assigned standards for Centers for Medicare and Medicaid Services (CMS) and /or Pennsylvania Department of Human Services (DHS) annual review standards, including oversight of delegated activities. Work with UPMC Health Plan departments and delegates to ensure that the CMS and DHS standards and reporting requirements are met
- Assume accountability for assigned standards from the National Committee for Quality Assurance (NCQA), including oversight of delegated activities. Work with UPMC Health Plan departments, such as Communication, Contracting, and Network Relations, Member Services, Claims Payment, Pharmacy Services, Utilization and Medical Management, Prevention and Wellness Services, Credentialing and other departments and delegates to ensure that NCQA standards are met and appropriate documentation is maintained
- Coordinate and conduct network physician education, initiatives related to HEDIS including HEDIS measure education, review of physician profiles and planning and implementation of improvement initiatives
- Demonstrate appropriate application of policies, procedures, and guidelines through continuous learning. Ensure that performance measurement is sufficient to produce meaningful and accurate results. Council, guide and instruct Health Plan employees on adherence to accreditation standards, HEDIS focused activities and other quality improvement initiatives
- Participate in the Health Plan Effectiveness Data and Information Set (HEDIS�) program, including data collection and abstraction, performing root cause analysis, designing and/or implementing improvement plans, and monitoring and reporting results in accordance with the department's designated work plan
- Perform duties and responsibilities in accordance with the philosophy, standards and policies and procedures of the UPMC Health System, including conveying courtesy, respect, enthusiasm and a positive attitude through all contacts with staff, health plan members, providers, peers and visitors
- Support and champion UPMC Health Plan safety initiatives as assigned
- Support the Health Plan's Complaint and Grievance process as needed including: Attending complaint and grievance hearings, serving as a voting member as needed. Conducting quality of care reviews, coordination of follow up, reporting of the activities and monitoring corrective action plans
- Support the UPMC Health Plan Committee functions and activities as assigned. Ensure that meetings are organized, well documented and that they meet the Health Plan goals and objectives and the individual Committee's roles and responsibilities
- Work is conducted within the time parameters and in accordance with UPMC Health Plan Policies and Procedures, the Health Plan's Quality Improvement Description and Work Plan as well as the requirements and expectations of the Pennsylvania Department of Public Welfare, The Pennsylvania Department of Health and any other state or federal agencies and accreditation agencies
- Bachelors degree in a health care field or equivalent work experience required. BSN or RN is preferred. Health related Masters is preferred
- 5 years of health care experience is required
- Proficiency in Microsoft Word and Excel required; PowerPoint and Access proficiency preferred
- Excellent verbal, written and presentation skills are required
- Professionalism, enthusiasm and initiative are expected
- Ability to work independently and as productive team member is essential
- Knowledge of the National Committee on Quality Assurance (NCQA)
- Standards for the accreditation of managed care organizations HEDIS specifications; the managed care environment and the basic tenets of continuous quality improvement are strongly preferred
- Experience with data collection, analysis and management is a plus
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Quality Improvement Summer Intern Saint Alphonsus Health Alliance Resume Examples & Samples
- Currently pursuing a Bachelor's degree or higher in healthcare or related field required; 3.0 GPA or higher preferred
- An interest and enthusiasm to work in healthcare operations required
- Attention to detail and ability to multi-task and juggle various projects required
- Ability to demonstrate thorough follow through, excellent communication, organizational and interpersonal skills required
- Advanced knowledge of Microsoft Office (Word, Excel, PowerPoint) and Access preferred
- Preferred Licensure/Certification: Certified Professional Coder, Medical Assistant, Licensed Practical Nurse
- Minimum of 1 year work experience in a healthcare setting preferred
- 0 GPA or higher preferred
- Meet's Health System's Guiding Behaviors and Caring Standards including interpersonal communication and professional conduct expectations
- Participation in Alliance events, such as man booth at health fairs, and staff and planning meetings across Alliance operations
- Assist in maintaining current Alliance website content in collaboration with Alliance website lead
- Generate/mail letters to members
- Request patient records from provider offices and facilities
- Maintains strict confidentiality of all data and information
- May be responsible for scheduling meetings to include physician peer review activities
- Valid driver's license required
- Participates in the department's day to day operations including providing general administrative assistance and support
- Assists leadership in identifying areas for process improvement and makes recommendations for streamlining processes
- Prioritizes multiple tasks and projects to ensure timely completion
- Performs special projects and other tasks as assigned
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Coordinator, Clinical Quality Improvement Resume Examples & Samples
- Works in a collaborative manner with physicians, administrators, department managers and others to identify and meet the continuous performance improvement requirements of the organization
- Provides education, consultative services and/or technical assistance to hospital departments, Performance Improvement Committees, Service Lines and Performance Improvement Teams
- Facilitates/leads organizational improvement activities utilizing the PDCA improvement methodology. Recommends tools and assists teams throughout the improvement process
- Conducts concurrent review of the literature and websites to provide teams and Service Lines with up to date evidence and best practice recommendations
- Conducts Failure Mode Effects and Criticality Analysis (FMECA)
- Works with Analytics and Business Intelligence (ABI) staff to determine performance metrics for key process and performance improvement initiatives
- Provides support to Medical Staff and Service Line Performance Improvement Committees
- Analyzes data reports and implements process to achieve improved performance
- Assists in the development of storyboards. Prepares graphics for presentation format
- Develops criteria/outcome measures necessary for disease management studies
- Conducts chart review for mortality and morbidity review
- Conducts Root Cause/Intense Analysis of adverse events
- Supports the vision of the Quality Resources Department by establishing performance improvement initiatives that meet the scope, depth and timeline requirements of the requestor
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Quality Improvement Support Coordinator Resume Examples & Samples
- Assists and supports HEDIS (preventative health and chronic illness gaps in care) Improvement field staff with initiatives and projects as needed for Mobile Events, in the office and out in the field
- Assists and supports the UPMC Health Plan HEDIS Office Based Data Collection (OBDC) and Network Quality HEDIS Medical Record Retrieval programs. Travel is required 25% of the time
- Assists in the development of material and resource information necessary for HEDIS education both internal and external of UPMC Health Plan
- Assists in the evaluation, compilation, and documentation of HEDIS Improvement analysis and reporting needs, including communication of those needs to the Director, and Executive Management for communication of project status
- Develops and maintains detailed project plans for new HEDIS Improvement initiatives
- Interacts effectively with all levels/departments within UPMC Health Plan
- Prepares and presents project status reports to the Senior Project Manager or other Management as required or needed
- Provides service to departments within UPMC Health Plan under the direction of the Senior Project Manager to assist in the management, coordination and implementation of projects and initiatives set forth by the HEDIS Improvement department
- Bachelor's degree or equivalent experience will be considered
- At least one year experience in a project-oriented department required
- HEDIS and CAHPS understanding is preferred
- Strong planning, organizational and communication skills (oral and written) are required
- Strong skills in Excel, Access, Visio, PowerPoint, Word and other software as needed for success
- Valid Driver License Required
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Quality Improvement Analyst Resume Examples & Samples
- We require a nursing degree from an accredited school
- You’ll also need a current RN license in our state
- Minimum of three to five years clinical work experience; Cardiovascular background preferred. Proficiency in computer skills to include at a minimum Windows environment and Excel or a willingness to undergo training to acquire these skills
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Medicaid Quality Improvement Senior Analyst Resume Examples & Samples
- Working closely with multiple teams including IT/Information Services, clinicians, project operations and community (external) partners
- Prior experience working in a consultative role, with strong problem-solving, written and verbal communications skills
- Advanced technical and analytical skills, with knowledge of common health care data sources (EHR, payor claims, hospital administrative data, etc.) and common national quality improvement performance measures (HEDIS, CG-CAHPS, etc.)
- Demonstrated experience with Excel, STATA, SPSS, SAS, SQL and/or other data analysis tools
- Understanding of relational databases, data systems and data warehouses
- Ability to express complex analytical and technical information to senior management or to audiences with clinical training
- Experience working in a clinical setting
- Must exhibit efficiency, collaboration, candor, openness and results-orientation
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Registered Nurse / Quality Improvement Hedis Resume Examples & Samples
- 1. Participates in clinical quality improvement programs and committees, performs follow up as necessary
- Develops and implements necessary teams, tools and care process changes in parallel with physician practices efforts to improve patient/member outcomes
- Participates in analysis of network aggregate results of existing clinical outcome measures. Collaborates with medical director and informatics resources to develop, monitor and analyze performance measures
- Reviews data on measure performance and helps implement the clinical quality program
- Works with outlier practices to improve performance
- Supports quality initiatives associated with value based contracts (both commercial and governmental)
- Performs other related duties, as required
- Some Travel to Outpatient Practices/Ambulatory Sites through Long Island/NYC
- Minimum of five (5) years of nursing experience, required
- Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS), Quality Assurance Reporting Requirements (QARR), National Committee for Quality Assurance (NCQA), Medicare Shared Savings Program Accountable Care Organization (ACO) and Group Practice Reporting Organization (GPRO) measures, preferred
- Knowledge of industry quality improvement methods and tools as well as program design, implementation and evaluation
- Proficient computer skills: MS Office applications, Word, Excel, PowerPoint and Access
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RN, Quality Improvement Resume Examples & Samples
- Reviews, investigates, responds to and resolves member complaints and/or grievances from Patient Services, health plans and other sources
- Analyzes, trends and monitors quality of care issues for reporting and recommendation of successful intervention
- Works in conjunction with Risk Management on any potential risk issues
- Maintains QI/peer review file of clinicians for credentialing/re-credentialing and any activities related to the preparation of files
- Conducts site and medical record reviews as directed
- Maintains confidentiality of peer review or other related information
- Prepares and coordinates agendas or other activities for QI and Peer Review Committees with the QI Chair, Peer Review Chair, RATs or others
- Assists in facilitating the education of staff and clinicians on quality improvement studies and HEDIS criteria
- Oversees, directs and evaluates support staff in their assigned duties
- Knowledge of Microsoft Word
- Statistical analysis skills
- Ability to make judgments regarding medical care
- Good interpersonal, verbal and written communication skills
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Quality Improvement Care Coordinator Resume Examples & Samples
- Calls patients to assist in obtaining medical appointments or to communicate information related to their medical care
- Communicates with patient regarding medical screenings and able to educate both patient and family regarding rationale and importance of screenings as directed by the physician
- Completes all administrative functions associated with referral activities in a timely manner. Maintains patient medical records in accordance with JSA policy and maintains proper assembly of medical records
- Follows JSA standing orders and protocols for proper authorization and processing of referrals. Follows JSA coding protocols
- Assists patients with external resources when needed
- Communicates with patient on a timely basis to meet quality measures and scheduling requirements. Communicates professionally with medical offices
- Receives consultant reports, maintains documentation, and routes to the appropriate physician promptly
- Responsible for monitoring referral reports not received and timely follow-up in accordance with JSA policy and procedure
- Using various data sources enters data into spreadsheets or programs
- Maintains call logs, excel spreadsheets, and data findings electronically
- Compiles, organizes, and mails out materials to internal and external customers
- Proficient in Excel spreadsheets required
- Knowledge of medical coding preferred
- Ability to communicate effectively with patients and all levels of personnel in a professional, courteous and effective manner using excellent customer service skills
- Possess excellent communication and organizational skills with the ability to multi task, set priorities, and meet deadlines
- Ability to work Monday-Friday flexible 8 hour shift schedule
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Manager, Quality Improvement Resume Examples & Samples
- Required - A Bachelor's Degree in HealthCare, Nursing, Public Health, Health Administration or directly related degree or equivalent experience
- Preferred - A Master's Degree in Healthcare
- Required - 5+ years of experience in directly related Quality Improvement job duties
- Required - 3+ years of experience in managed care
- Required - Previous experience working with HEDIS measures
- Required - Knowledge of JCAHO, URAC, AAAHC and NCQA standards
- Required - Previous experience managing a team of direct reports
- Preferred - Experience with Medicaid/Medicare
- Ability to effectively present information and respond to questions from families, members, and providers
- Ability to effectively present information and respond to questions from peers and management
- Required - Experience working with Microsoft Word, Excel, PowerPoint and Outlook
- Preferred - Previous experience working in a Healthcare Management Systems
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Quality Improvement Support Coordinator Resume Examples & Samples
- Assists and supports the UPMC Health Plan HEDIS Office Based Data Collection (OBDC) and Network Quality HEDIS Medical Record Retrieval programs
- Travel is required 25% of the time
- Bachelor's degree or equivalent experience preferred
- At least one year experience in a project-oriented department preferred
94
Quality Improvement Program Director Resume Examples & Samples
- 5+ years of experience in a Healthcare setting
- NYS Registered Nurse (RN) license
- Progressive Administrative leadership experience in Quality Improvement
- Experience with Performance Improvement and Project Management
- NYS Licensed Clinical Social Worker (LCSW) and/or Licensed Master Social Worker (LMSW)
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Quality Improvement Projects Engineer International Assignment Resume Examples & Samples
- To ensure availability of data either by manual collection or by implementing systems for data collection, motivating users to record data and ensuring discipline in recording the data
- Transferring data to common places and transforming data into common formats for further use
- Supporting the analysis of the data
- Organizing and moderating problem analysis and problem solving activities
- Follow up of implementation of actions and measuring the effectiveness together with other team members including process capability and Statistical Process Control (SPC)
- Minimum bi-lingual : English required Italian would be a great benefit
- Preferable experience in Quality
- Strong communication skills, able to communicate in the team
- Strong presenting skills
- Structured and organized personality
- User ability for working with standard SW excel, Word, Minitab will be appreciated
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Director, Quality Improvement Resume Examples & Samples
- Leads the development, implementation and management of Quality Improvement initiatives within the health plan
- Collaborates with health plan Chief Medical Officer in overseeing medical service delivery and quality of care for health plan members
- Support provision of high quality clinical care by building strategic relationships with health care providers
- Support maintenance of marketable, high quality, cost effective provider networks
- Coordinates, directs, and manages the activities of the department and the quality management program
- Responsible for the analysis of the quality of member care, both individual and systematic, received and for the development of plans and programs to support continuous quality improvement
- Establishes strategic plans, policies, and procedures to ensure quality programs are consistent with overall MHI quality strategies
- Responsible for the investigation and resolution of all quality of care grievances and critical incidents, if applicable to the State Health Plan
- Establishes and coordinates the committees and sub-committees of the department that report to national committees and / or to the State Health Plan Board of Directors
- Minimum of 7+ years relevant experience, including at least 5 years in health plan quality improvement
- Demonstrated knowledge of and experience with HEDIS programs
- 2 years Medicaid experience
- 2 years Medicare experience
- Minimum 3 years people management experience
- Operational knowledge and experience with Excel and Visio (flow chart equivalent)
- NCQA Accreditation experience
- 10+ years, including
- HEDIS reporting or collection experience
- CAHPS improvement experience
- State QI experience
- 3 years experience in Reporting & Analytics
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Quality Improvement Program Director Resume Examples & Samples
- Bachelor’s degree in a technical or scientific field with 10+ years’ experience OR Master’s degree in technical or scientific field with 8+years of experience
- 8+years of experience in quality, R&D, operations, clinical, engineering and/or regulatory
- Comprehensive knowledge of GMP and ISO 13485:2003 regulations, product design, manufacturing, supply chain, and/or distribution processes
- Experience with CAPAs and/or continuous improvement activities
- Experience leading teams (directly or indirectly)
- Prior experience managing the quality system in a manufacturing and/or product design environment
- Strong preference for experience in medical devices and/or pharmaceuticals
- Broad understanding of US and International regulations including 21 CFR 820
- Influence management skills; demonstrated ability to work constructively across all functions of the organization
- Experience presenting, interacting, and building effective relationships with regulatory agencies
- Excellent communication and presentations skills (articulate and persuasive)
- Strong team management and leadership skills. Ability to create strategies, define and articulate clear role expectations and direction. Ability to translate quality initiatives into specific objectives, metrics, and action plans
- Willingness to “do what it takes,” including direct auditing activities at times
- Ability to attract, develop, and retain diverse talent
- Proven experience in achieving results through influence management and motivating teams
- Masters or Advanced degree preferred
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Clinical Quality Improvement Analyst Resume Examples & Samples
- Bachelor’s Degree in Nursing required. Master Degree in Business Administration or healthcare related field preferred
- 5 years clinical practice experience
- Certification by the Healthcare Quality Certification Board (HCQB) as a Certified Professional in Healthcare Quality (CPHQ). If not currently certified, certification must be obtained within 18 months of employment
- Registered Nurse with current State of Ohio license
- Proven experience performing comprehensive data analysis including financial and clinical
- Understanding of utilization patterns/standards, quality of care and cost effectiveness issues as acquired through previous utilization review, quality management administration with study design background
- Demonstrated project management skills with the ability to handle multiple, concurrent projects through to completion
- Problem-solving skills with the ability to identify improvement opportunities and recommend solutions to problems
- Intermediate MS Office Skills, including MS Access
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Senior Hedis & Quality Improvement Analyst Resume Examples & Samples
- Analyzes data across multiple systems and develops reporting, advanced analyses and actionable recommendations to improve quality as measured by health plan metrics. Assists in the development of customized models and scenario analyses to monitor projected measure scores and results throughout the year. Works in collaboration with multiple departments to support implementation of performance improvements interventions and initiatives directed to members and/or providers
- Develops reports to enable monitoring monthly and annual performance in relation to national and regional benchmarks. Performs monthly, rate, impact, and trending analyses. Conducts evaluation studies and causation analyses to determine the effectiveness of interventions and initiatives directed to members and / or providers. Provides advanced analytical and technical support for the design, development and maintenance of quality improvement initiatives. Assists in the production of provider report cards and reports of gaps in care, as well as detailed analyses of specific measures
- Maintains up-to-date knowledge and advanced understanding of technical specifications for all measures
- Communicates effectively through written reports, graphical representations, and oral presentations to internal and external stakeholders. Provides education and training to departments regarding concepts, analyses, and analytic tools
- Minimum of a BA or BS in Health Analytics, Public Health, Health Care Administration, Health Economics or a related field with strong emphasis in data analysis; Master’s degree strongly preferred
- Minimum of 5 years of experience in reporting and analyzing quality improvement measures in health plan, with at least 1 year of experience evaluating the effectiveness of interventions and initiatives to improve health plan performance on quality measures
- Able to work with minimal direction and flexibility when rapid or extensive changes are needed
- Strong leadership skills with the ability to effectively work with diverse individuals and teams
- Intermediate to advanced knowledge of analytic programming languages and data visualization tools, including SAS, SQL, Cognos, and Tableau
- Extensive knowledge of NCQA and CMS measurement requirements and quality rating systems
- Demonstrated analytical ability with identifying opportunities and proposing solutions
- Demonstrated ability to develop and produce complex reports and dashboards
- Experience and expertise with designing and executing analyses to evaluate the effectiveness of interventions and initiatives to improve quality
- Advanced knowledge of health plan operations and data sources
- Well-developed business sense
- Ability to organize, plan and prioritize assignments within multiple projects
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Quality Improvement Program Specialist Registered Nurse Resume Examples & Samples
- Represent Quality and Compliance and BCBSMA as the subject matter expert as it relates to FEP quality improvement activities, benefits and QCR activities
- Analyze current QCR and HEDIS performance, identify areas for improvement and develop initiatives that leverage OPM benefit design and BCBS Association activities
- Work in collaboration with FEP leadership team to coordinate, develop and implement a QI annual work plan
- Develop materials for clinical and operational departments as appropriate on key operational metrics and quality improvement measures such as HEDIS
- Develop and implement targeted member outbound calling campaigns to address areas of opportunity with regard to QCR and HEDIS performance
- Participate in HEDIS chart review process
- Develop a FEP specific response to NCQA QI 6 and Mem 8 and evaluate compliance and function as a resource regarding the elements and standards for NCQA
- Coordinate committee work, facilitate effective meetings, including completion of minutes and monitoring progress toward charter
- Apply the concepts Continuous Quality Improvement and use CQI tools to facilitate improvement. Collect, analyze and validate data used in quality initiatives within Health and Medical Management
- Develop collaborative working relationships with other divisions within BCBSMA such as prevention and wellness, member services and field services, to further QCR improvement and enhance performance on this measure set
- Work with leadership in FEP to identify through data process improvements in UM/CM that align with QCR measures to maximize quality, efficiency and affordability within FEP
- Present formal reports and summary presentations both within BCBSMA and to external audiences (providers and/or, delegated entities etc.)
- Keeps Sr. Manager of Quality and Compliance informed of key issues, risks, timetables, project milestones and areas of focus
- Other responsibilities as identified by Senior Manager of Quality and Compliance
- Knowledge of Continuous Quality Improvement methodologies and tools specifically HEDIS
- Familiarity with regulatory and accreditation standards, such as NCQA
- Experience with auditing, measurement and data analysis
- Experience with motivational interviewing and ability to work with members on gap in care
- Ability to apply critical thinking skills to major responsibilities and deliverables
- Demonstrated ability to facilitate teams, work cross-functionally and build consensus
- Proven excellent interpersonal, verbal and written communications skills
- Ability to adapt in a fast-paced dynamic organization
- Bachelors degree required
- RN or clinical professional with active Massachusetts license preferred
- 3 years clinical experience or experience in managed care industry
- 3 years experience in quality improvement
- CPHQ certification a plus
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Sepsis Quality Improvement Program Manager Resume Examples & Samples
- Collaborate with hospital and system leadership to develop a comprehensive program through the implementation of systems to support compliance with evidence based standards of care and improved patient outcomes
- Provide oversight to MSHS hospitals to facilitate alignment of short and long term goals, program objectives, policies and operating procedures and communication strategies for the MSHS Sepsis QI Program
- Consult with system hospitals and stakeholders on operational aspects and scope of a project(s), including supporting the creation and execution of project work plans and the development of education plans
- Provide leadership to and coordinate the execution of day to day program activities to meet program objectives
- Participate in and conducts analysis to identify process improvement opportunities as needed; identify patterns and/or trends for program improvement across the health system
- Serve as liaison and ensures appropriate builds to electronic health records
- Provide timely status reports to MSHS Program leadership
- Identify best practices and tools to support/refine project goals and implementation of the MSHS sepsis protocols
- Prepare reports and analysis associated with the quality improvement programs for stakeholders including senior management and departmental and clinical program leads
- Develop an annual quality improvement plan with established goals and priorities
- Build and promotes positive working relationships with all stakeholders to foster successful project implementation
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Coordinator, Continuous Quality Improvement Resume Examples & Samples
- Develops and schedules a program/event work plan in accordance with specifications, objectives and funding limitations
- Serves as a representative to ensure all aspects of function/program are implemented and controlled according to plans
- Provides assistance and information to faculty, staff and outside organizations regarding function/program
- Provides leadership training and organizational management opportunities through workshops and seminars to targeted groups
- Attends seminars, workshops and conferences
- All other duties as requested by the Director and Vice Dean
- Bachelor’s degree in a field appropriate to the area of assignment AND three (3) years of providing advance project support; OR, Any equivalent combination of education and/or experience from which comparable knowledge, skills and abilities have been achieved
- Four (4) years administrative/coordinative program experience
- Familiarity with accreditation or credentialing
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RN Quality Improvement Front Line Leader Resume Examples & Samples
- Active RN license in designated state(s) without restrictions
- Associates degree in nursing
- Demonstrated experience in leading teams
- A minimum of 2-5 years of experience in directly related HEDIS medical record review and Quality Improvement with experience in clinical data/chart reviews and providing clinical consultation and education to providers and provider staff
- A minimum of 2-5 years of experience in a managed care health services or hospital/clinical environment
- Strong ability to implement process improvements & drive strategic Initiatives
- Understanding of data analysis and continuous quality improvement process
- Demonstrating interpersonal/verbal communication skills
- Able to demonstrate strong presentation skills
- Effective consultation and influencing skills
- Advanced Knowledge of medical terminology and/or experience with CPT and ICD-10 coding
- Intermediate - advanced with Microsoft Office applications
- Bachelor’s or Master’s Degree in Health Care or related field
104
Quality Improvement Engineer Resume Examples & Samples
- Ability to interpret and implement customer quality systems and procedure requirements. In addition, the ability to ensure implementation is across plant operations and is in alignment with customer’s quality standards, policies, and expectations
- Cultivate and maintain positive working relationship with both domestic and international customer through excellent communication skills, positive attitude, superior organization, and responsiveness
- Oversee alignment of all quality related activities for the development, production, and certification of all the customer product line (from Purchase Order to product shipment). Ability to perform contact reviews
- Ability to effectively communicate Arconic shortfalls internally, develops action plans, and gain cooperative alignment within Arconic to make substantive improvements in overall relationship with this customer
- Ability to use quality tools to respond and resolve customer concerns
- Ability to act on behalf of the Quality Manager
- Schedule and perform internal/external audits
- Perform Raw Material Release (MetOK)
- Maintain supplier qualifications and Approved Supplier List
- Participate in Customer and Regulatory audits
- Perform Risk Management activities associated with nonconforming product (including preventive actions)
- Investigate root cause and implemented effective corrective actions
- Responsible for leveraging improvements between Rancho and Verdi facilities
- Provide hands-on training as required to implement improvements
- Coordinate cross-functional improvement activities
- Develop a report-out and/or tracker system to monitor effective and sustained improvements
- Liaise with production to understand risks and identify improvement opportunities
- Strong organizational skills; proactive and self-directed
- Ability to prioritize in a fast-paced environment
- Bachelor’s Degree from an accredited Institution
- Minimum 2 years of experience in Manufacturing
- Prefer the Bachelor’s Degree is in Engineering or Business
- 3+ years of experience in Aerospace manufacturing
- Experience in the forging industry
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Supervisor, Quality Improvement Resume Examples & Samples
- Provide supervision for appeals and grievance, quality of care/service; provider redeterminations and other applicable department activities including policies, procedures, workflows, letters, and reports
- Communicate and reinforce standards for the quality team
- Prepare any applicable department state, federal, or accrediting body reports and submit timely
- Prepare other quality review reports on departmental findings, identifying individual and organizational trends
- Identify and analyze team performance trends, address barriers, and recommend process improvements
- Ensure non-clinical and clinical audits are conducted according to established tools and standards
- Provide recommendations for development, or revision of policies, procedures, work flows, documents or other documents to be used for training content or skill acquisition
- Research and respond to complex quality of care or quality of service, appeal and grievance or provider redetermination inquiries
- Coordinate with management to ensure the department output is meeting goals, expectations and requirements in alignment with the quality improvement department and program description and work plans
- LPN/LVN or graduate from an Accredited School of Nursing and RN License. Bachelor’s degree in related field preferred
- 5+ years of clinical experience in health care
- Managed care experience preferred. Previous experience in supervisory role, quality assurance preferred
- Strong computer skills, including experience with Microsoft office and/or quality monitoring systems
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Quality Improvement & Risk Manager Resume Examples & Samples
- Serves as staff to the Chair of Quality Committee (Center President) to ensure the Quality Committee fulfills the basic requirements of CQIP filed with the State of Washington
- Ensures that all subcommittees of the Quality Committee meet as required and facilitates subcommittee reporting to Quality Committee
- Serves as a member on the Employee Safety Committee
- Manages event reporting team regarding investigation and mitigation of events reported through the ROILS system. Ensures follow through of identified improvements and reporting to the Patient Safety Committee and Quality Committee
- Ensures appropriate responses to patient complaints and UW/SCCA Risk Management issues related to Center faculty
- Provides input into improvement priorities based on appropriate risk assessments and other data sources
- Educates staff on quality assurance, quality improvement, and HIPAA Privacy
- Implements annual all-staff education requirements
- Manages the physician credentialing and privileging process
- Works with insurance brokers and Finance team to facilitate implementation of annual insurance strategy
- Facilitates SPC clinical research coordination team and assists with the completion of all documentation allowing the Center to be a site for clinical research. Works closely with the UW Radiation Oncology research coordinators
- Maintains the electronic document library (PPM). Works with leadership and management team in the timely creation, and ongoing review of Center policy and procedures
- Facilitates third party audits as appropriate (e.g. ACRO; ASTRO; CMS; Department of Health, etc.)
- Responds to compliance and ethics reports received via the hotline or web portal. Coordinates with Human Resources Manager to investigate and resolve reports as needed
- Coordinates with the Radiation Safety Officer to ensure compliance with the Radiation Safety Program
- Collaborates with Chief Financial Officer on financial/billing audits as needed
- Minimum of five years working in Quality Improvement or a combination of Quality Improvement and Risk Management in healthcare environment
- Oncology experience preferred
- Knowledge of basic quality improvement and patient safety principles and tools
- Knowledge of ACR, ACRO, and ASTRO accreditation requirements
- Able to interact with all levels of personnel
- Technical problem solving
- Excellent computer skills, including use of Microsoft Office products
- Teaching and coaching skills
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Quality Improvement Coord Resume Examples & Samples
- Provides effective Project Management/Leadership to ensure completion of Medical Center Quality and Performance Improvement projects to meet goals and objectives
- Clinical Expertise: Demonstrates clinical expertise in specific patient population(s) related to projects managed
- Technical Execution: Demonstrates technical execution in collection, verification and analysis of data
- Leadership & Training/Development: Provides leadership and training/development to project team members
- Communication & Interpersonal Skills: Communicates effectively with all levels of internal and external personnel
108
Program Director, Quality Improvement Resume Examples & Samples
- Leads key Clinical Intervention activities including implementation of national and state-based Quality interventions, meeting state and federal intervention rules and aligned with best practices identified in literature and within Molina plans
- HEDIS reporting or collection experience
- CAHPS improvement experience
- State QI experience
- 3 years experience in Reporting & Analytics
- 3 years experience in Health Care Industry
- Quality program leadership and direction
109
Improvement Project Manager Institute Healthcare Quality Improvement Resume Examples & Samples
- IHQI’s course “Physician Engagement in Quality and Safety” helps physicians gain a solid foundation in quality improvement by highlighting the safety and quality challenges facing healthcare, sharing case studies of improvement initiatives and defining physicians’ role as leaders in improvement work
- IHQI’s Faculty Development Program promotes professional development in quality improvement through mentoring, training, and educational programming
- Develop and monitor project plan including deliverables, milestones, tasks and timeline
- Plan and coordinate meetings and improvement activities involving project stakeholders including clinical and administrative leaders and line staff
- Communicate with project stakeholders and team members regarding project status, tasks, implementation challenges, etc. during and between meetings and improvement activities
- Plan, coordinate and facilitate project team meetings
- Manage project budget and expenditures
- Create project documents and materials (e.g., charter, key driver diagram, A3s, run and/or control charts, standard work, training materials, tools to support clinical operations, progress reports, presentations, etc.)
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Manager, Quality Improvement & Appeals Resume Examples & Samples
- Directs preparation of Quality Reports internally to support management review of standard processes, staff functions, departments
- Maintaining a professional quality department staff with sufficient knowledge, skills, and experience sufficient to meet the requirements of the department
- Issuing periodic reports to the audit committee and management summarizing results of audit activities
- Directs all Grievance/Appeals functions
- Provides leadership and review of the Complaint, Appeals, and Quality process, including identification of trends and recommended action to address
- Several Key activities required of the Manager are inherent in the above objectives, but are also useful to be listed separately
- 5 years’ proven leadership responsibilities and success in managing the health care environment required
- 3 years of quality improvement experience required
- 5 years’ experience in clinical and/or managed care operations required
- At least 5 years clinical quality auditing experience preferred
- Certified Professional in Quality Improvement (CPHQ) preferred
- Extensive knowledge of the Medicaid preferred
- Proven ability to conduct root cause analysis, plan, organize and coordinate multiple projects
- Proven ability to speak in public and conduct effective presentations
- Employee may be required to participate in Runzheimer Program (auto reimbursement program)
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Quality Improvement Reviewer Resume Examples & Samples
- Conducts deep analysis of patient care experience using Electronic Health Record (EHR)
- Develops summaries of quality concerns and presents to quality committees for discussion
- Serves as an active member on quality committees to include Medical Staff Quality Improvement (MSQI), Emergency Department Quality Improvement (ED QI) and Trauma Quality Improvement
- Maintains ongoing Excel spreadsheet log of current and completed cases for tracking, trending and quality improvement
- Conducts concurrent and retrospective reviews using IRIS reports or other forms of reporting tools upon request from the Quality Improvement Director or Administration
- Conducts clinical review of patient care episodes and patient safety indicators (PSI-90), identifies areas of concern for appropriateness, and makes recommendations for improvement
- In conjunction with Pathology Medical Director, reviews blood products usage utilizing current criteria developed by Pathology/Medical Staff. Conducts blood usage audits as needed. Provides quarterly report to Medical Staff Quality Improvement Committee. Oversees and conducts analytical EHR chart review related to patient safety and quality outcomes/processes. Collaborates with Nursing and Medical Staff leadership to determine appropriate referrals and further reviews
- Prepares monthly Credentials Reports as requested by Credentials Committee and the Medical Staff Office using Premier Physician Focus and Peer Review Manager
- Minimum of five (5) years nursing acute care clinical experience (minimum 24 hours/wk) required
- Familiarity with Premier Physician Focus and Peer Review Manager preferred
- Minimum of two (2) years of quality improvement experience and performance improvement experience in review and analysis of patient cases required
- Excellent communication and interpersonal skills in relating to public, peers and physicians required
- Demonstrable proficiency in Microsoft Word and Excel as well as in review and analysis of patient cases required (successful completion of test required)
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Senior Manager, Global Quality Improvement Resume Examples & Samples
- Support the development of performance improvement training and tools to be leveraged by Continent above-property and property Operations leaders, e.g. creating and executing training webinars
- Assist with implementation, tracking and compliance of quality improvement tools
- Summarize key insights, learnings, and feedback related to quality improvement tools, e.g. periodic continent-level insights from various data sources such as guest feedback
- Day-to-day resource to help build new programs and enhancements for Marriott’s global operators
- Develop recommendations and/or research creative, cost-effective quality improvement opportunities, incl. cost/benefit analyses, stakeholder analyses, and competitive assessments
- Assess opportunities to leverage learnings from best-in-class brands such as The Ritz-Carlton to “right-size” tools for Marriott’s lower tier brands
- Support Continent property and above-property users in the application of Marriott quality tools and operations programs
- Act as a subject matter expert in Marriott quality improvement tools, incl. the delivery of training and presentations to end-users such as General Managers, Area Vice Presidents, etc. (primarily focused on guest feedback from guest surveys, social media, independent audit results, and related sources)
- Assess progress and impact of existing and new programs delivered to drive quality improvement across several brands and continents, incl. pre/post metrics
- Assist with ad hoc support needed on guestVoice platform (Marriott’s guest satisfaction and social media listening platform)
- Develop and/or facilitate performance improvement breakouts at key Brand and Owner meetings (e.g., GM Conference, Owner Conference)
- Deliver trainings and presentations to key audiences on topics related to quality improvement
- Collect, monitor, and assess feedback related to tools and services provided by Quality Improvement team
- Support delivery of appropriate data and reporting to enable Marriott senior management to meet guest experience goals
- 4-year bachelor's degree from an accredited university in Business Administration, Hotel and Restaurant Management, or related major; plus 5 years’ experience in Operations, Quality Improvement, Consulting, or related professional area; OR related work experience
- Graduate / advanced degree preferred (e.g. MBA)
- Certification and/or training in quality, process improvement, Six Sigma, project management, etc. preferred
- Senior Manager, GO, Global Quality Improvement
- Experience of cross-functional, or matrixed teams
- Experience in customer and vendor management
- Database, spreadsheet, and technology user experience
- Strong analytical and problem-solving skills, incl. strong attention to detail
- Strong verbal, presentation and written communications abilities
- Ability to articulate new concepts clearly and in a compelling way
- Negotiating, influencing and problem resolution skills
- High proficiency in Microsoft Office, especially PowerPoint & Excel
- Experience in developing and delivering training
- Expertise and proven track record in managing complex, multifunctional initiatives
- Proven track record of success working in or with fast-paced, consumer focused organizations
- Proven ability to effectively prioritize and execute tasks in a high-pressure environment within budgets and timelines
- Demonstrated ability to assess stakeholder needs, creatively approach solutions, and decide and influence appropriate courses of action
- Experience within Lodging or Hospitality industries, preferred
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Manager Quality Improvement Resume Examples & Samples
- Bachelor’s degree in Management, Public Health, or other healthcare related degree
- A combination of education and managed care experience
- Ten (10) years leadership and management experience with a focus on NCQA accreditation, with five (5) years experience in an HMO setting responsible for data and NCQA-compliant quality management programs
- Master’s degree in business or public health
- Clinical and/ or physician group quality management experience
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Director of Quality Improvement Resume Examples & Samples
- Evaluate clinical work systems and recommend and implement actions aimed at improving efficiency, effectiveness and regulatory compliance
- Motivate staff in the adoption of a culture driven to achieve excellence through continuous performance improvement
- Assist agency leadership in achieving and maintaining regulatory standards of external stakeholders and Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation
- Complete and submit data required by regulatory and accreditation organizations
- Participate in and conduct internal and external audits to maintain regulatory and voluntary accreditation
- Coordinate the collection and interpretation of data related to process and quality improvement
- Analyze data regarding quality indicators and recommend strategies to improve clinical performance
- Ensure proper authorization for all clinical services provided and assist program managers in ensuring proper level of care is routinely provided
- Assist in review, creation, update and maintenance of quality improvement, training policy, and procedure manuals
- Participate in strategic planning process as it relates to quality improvement processes and staff training plan
- Monitor progress and completion of goals related to quality systems
- Be responsible for the directing the design, development, evaluation, continuous improvement, and maintenance of training initiatives for the DeKalb CSB
- Perform task analysis to identify and develop appropriate training resources and procedures for clinical, administrative and developmental disability staff
- Responsible for leading the agency Staff Development Team and all agency training activities and initiatives
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Quality & Improvement Analyst Resume Examples & Samples
- Previous experience in internal auditing would be beneficial
- Confident at management information reporting
- An understanding of ISO Standards
- If you have your ITIL V3 Foundation that would be great
- Able to build strong relationships with other areas of the business, colleagues and stakeholders
- Clear and concise communicator, able to influence at all levels
116
Quality Improvement Administrator Resume Examples & Samples
- Requires an AS in nursing; 3 years of clinical experience as well as managed care or clinical quality improvement experience; or any combination of education and experience, which would provide an equivalent background
- Current unrestricted RN license in the State of District of Columbia preferred. BSN preferred
- Knowledge of health care delivery systems, and continuous quality improvement principles required
- Knowledge of NCQA, state and federal guidelines preferred
- Computer skills: MS Word, Outlook, Excel
117
Research Quality Improvement & Training Manager Resume Examples & Samples
- Actively lead or assist activities in the areas of Internal Quality Audits, CAPA (Corrective and Preventive Actions), Production support, Quality Management Reviews, and Quality Audits specific to, but not limited to US Oncology Research clinical trials. Support the development of GCP/ICH compliant processes which control the quality of work and clinical trials conducted at research site. Works with practice QA Coordinator to develop and evaluate process flows as they relate to USOR studies. Ensures that practice personnel are provided required documents in a timely manner for practice required reviews. Monitors the study startup process and works with practice QA coordinator to evaluate the effectiveness of this process. Reviews backlog with practice QA Coordinator to develop an action plan
- Lead study review activities to ensure that studies are conducted in accordance with sponsor protocols, GCP, industry guidelines, FDA regulations, and site policies and procedures. Lead or assist with identifying non-conformances with requirements, provide suitable recommendations and facilitate ongoing quality improvements using risk-based methodology while maintaining compliance with applicable study protocols, Quality System Regulations and or ISO standards where applicable
- Conducts new hire staff training on USOR processes and SOPs. Provide ongoing staff training and development for all staff to ensure high quality data submission and protocol adherence
- Reviews site audit reports with practice-based research staff and administration and works collaboratively with USOR Central and Site Service Manager to execute action plans
- Completes and submits written research QA site audit reports to practice QA Coordinator and practice research leaders on a monthly basis
- Serves as the on-site liaison between USOR and practice for all issues related to the conduct of clinical research and USOR clinical trials
- Proficiency with computer systems and Microsoft Office Suite (Outlook, Word, Power Point, and Excel) required
- Knowledge of GCP, ICH and FDA guidelines
- Experience with collecting and/or reviewing data for clinical research studies
118
Quality Improvement Assistant Administrator Resume Examples & Samples
- Demonstrated understanding of clinical care, standards of care and the ability to identify quality of care concerns
- Demonstration of strong writing and verbal communication skills sufficient to convey clinical case information to physicians, staff, senior leadership and external partners
- Proven record of accomplishment in facilitating multidisciplinary working groups including physicians, administrative leaders and staff
- Demonstrated leadership within a research or teaching environment
- Demonstrated ability to manage HR activities for a team of professional staff including hiring, leadership development, counseling and disciplinary action when indicated
- Ability to use computer database systems and understand basic IT programming capabilities to assist with the development of processes coordinating and disseminating information across a complex system
- Experience with coding medical record chart information and/or collecting clinical data in a quality improvement setting
- Master's Degree or higher in a clinical, health services or health care administration discipline or comparable experience
- Experience with state, federal and agency standards and regulations
- Experience with Root Cause Analysis and advanced Quality Improvement tools
- CPHQ, ARM or equivalent certification
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Quality Improvement Analytics Manager Resume Examples & Samples
- Participates on multi-disciplinary clinical quality improvement teams
- Participates in the training/mentoring of leadership in performance improvement methodology
- Works with project teams to develop and implement measures
- Designs complex data analysis tools
- Analyzes and organizes data to facilitate targeted clinical interventions aimed at improving patient care and institutional strategic planning
- Conducts analysis to ascertain the most efficient, effective and productive processes to accomplish department goals
120
Coord Quality Improvement Resume Examples & Samples
- Assists with analysis and implementation of Performance Improvement and Patient Satisfaction strategies, goals and objectives consistent with the System’s Strategic Plan and in accordance with the Mission and Philosophy of Presence Health
- Assists with the design, implementation and maintenance of the Holy Family Medical Center Performance Improvement Plan
- Participates in activities to ensure that Performance Improvement activities are operational and that desired outcomes are achieved by assisting in data aggregation, compilation and evaluation of the facilities’ Performance Indicators and assisting in creating performance improvement action plans when necessary
- Demonstrates current knowledge of Performance Improvement principles, tools, and concepts. Identifies educational needs, develop plans, and educates acting as a resource to all departments
- Participates in Performance Improvement activities to promote achievement of the principles of the PI Plan. Provides necessary education to staff, and assists in the development and implementation of multidisciplinary initiatives, data collection and analysis
121
Director, Clinical Quality Improvement Resume Examples & Samples
- Ensures processes are implemented to evaluate and identify opportunities for improvement in the provision of high quality, safe and resource effective medical care to its patients
- Monitors, in partnership with the medical staff, the measured outcomes of hospital clinical care activities, identifies opportunities for improvement, and leads clinical improvement activities to improve those measured outcomes
- RN degree preferred, with experience in quality/performance improvement, and as applicable in case management and other related areas of responsibility OR a Bachelor's degree or higher in a health related field with 5 years of relevant hospital management experience OR other allied health professionals who have at least 7 years of hospital experience in the areas of responsibility
- Demonstrated knowledge of Performance Improvement, Outcomes and Quality Management
122
Dental Quality Improvement Officer Resume Examples & Samples
- NVQ 3/A Levels or equivalent
- Specialist knowledge of quality improvement and/or audit systems
- Evidence of ability to explore customer's needs and adapt the service accordingly to ensure a quality service is delivered
- Fluency in Welsh, in written and oral
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Clinical Quality Improvement Resume Examples & Samples
- Participate in the activities of the Quality Improvement HEDIS Stars Program to identify, develop and implement initiatives and projects as assigned
- Work collaboratively with internal and external management and resources (staff and contractors) to optimize information available for Stars
- Work collaboratively to define potential quality improvement –STARSactivities within the corporation, at the individual or group practitioner level, facility level or network system level. The quality improvement – STARS activities could include third party collaboration. Participate with operating teams in the development, implementation, evaluation and updating of processes and initiatives
- Perform clerical functions to include; medical record request, faxing and calls to members and providers as needed. Maintain organized, updated reporting of activities with clear documentation
- Perform medical record reviews when necessary to support improvement and compliance, abstract HEDIS data, to include over-read of reviews, working collaboratively with internal audit team
- Provide support with the review analysis and reporting of CCIPs, QIPs and other regulatory requirements as needed. Monitor industry standards and other available information from internal, external and publically available data
- Master’s degree or equivalent experience
- Health Policy and Health Insurance Industry experience
- Experience in or working knowledge of Quality Improvement Initiatives, HEDIS, Medicare Stars and Quality Rating Systems
- Project Management Experience
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Quality Improvement &standards Manager Resume Examples & Samples
- Collaborates with pertinent departments within the medical center to achieve compliance with standards and regulations
- Reviews policy and procedure manuals
- Assists with CLIA and CLEP
- Oversees the submission and renewal of licenses, certificates and continuing education
- Tracks accreditations of the different modalities to ensure timely submission
- Manages the collection of checklists, logs, surveys, and all other documentation to meet the required standards of care. Disseminates pertinent information to all facilities
- Coordinates and serves as a resource for occurrence review
- Conduct regular environmental inspections with department supervisors to ensure compliance
- Organize and establish in-services for ambulatory staff
- Trains, coaches and/or mentors staff in the methods and tools of continuous quality improvement and root cause analysis
- Participates in enforcing the regulations governing a multi-specialty ambulatory clinical care center in accordance with article 28 regulations
- Reviews and disseminates information pertaining to Joint Commission and NYS DOH compliance activities
- Oversee AAASF recertification for ambulatory sites
- Coordinate AAAASF accreditation for new ambulatory sites
- Serve as on and off site resource to improve clinical operations through process improvement, strategic planning, managing change in the workplace and building teams
- Identifies need for and assists in design, implementation and monitoring of operational processes/activities to assure compliance with standards and facilitate ongoing survey readiness
- Assists with other regulatory responsibilities as assigned
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Quality Improvement Project Manager Resume Examples & Samples
- Act as a professional role model and lead to other project coordinators, and may oversee their day-to-day activities
- In collaboration with NYULMC Information Technology staff, assure that applicable interfaces with other pertinent interfaces are established and maintained
- Develop internal quality performance measures and regular reports, to support departmental and organizational improvement goals
- Assure timely and accurate data submission to regulatory and external quality performance measurement registries
- Manage project meetings using project plans to meet key deadlines and ensure progress on the project
- Assemble and maintain project plans and documentation of project progress and tracking key milestones using standardized project management tools, in accordance with departmental and organizational guidelines
- Lead interdepartmental and inter-organizational projects as determined by Departmental leadership
- Participate in and act as a lead in clinical quality performance measurement and improvement activities in the Department of Clinical Quality and Effectiveness
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Senior Coordinator, Quality Improvement Resume Examples & Samples
- Facilitates improvement initiatives, which includes but not limited to, monitoring trends in metrics, works collaboratively with physicians, administrative leadership, professional and paraprofessional staff in rapid cycle PDSAs
- Collaborates with the Information Technology team to streamline and use technology, ie automation to facilitate the overall quality improvement activities, which would include data collection, metrics development, publication of metrics and or improvement results
- Assists in the integration of PCMH standards and guidelines into the overall Quality Improvement Plan. This position/role is a designated lead resource in PCMH certification
- When appropriate completing/revising configurations in the electronic medical record (identified through event investigations), specifically improving documentation, simultaneously enhancing the networks risk reduction program
- Communicate investigation findings, track issues to resolution and recommend improvement protocols to prevent further similar incidents and or correct adverse patterns/trends where found
- In collaboration with the Director of Risk, investigates reported and suspected deviations in patient care outcomes and near miss situations, facilitates appropriate review by physician, and/or other professional staff, as appropriate
- Completes the investigation and review process of such deviations according to policy
- Participates in assigned standing committees and improvement teams. Acts as Team Leader or Facilitator, for improvement teams
- Facilitates development and implementation of training curricula impacting on the PCMH recognition, the quality improvement plan and electronic medical record for new employee orientation
- Execute other tasks as assigned
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Cdoc-quality Improvement Administrator Resume Examples & Samples
- Graduation from an accredited college or university with a bachelor's degree in a Health Care field. You must attach a copy of your transcripts that contain the name of the college/university, type of degree received, date the degree was awarded, your name, last four of social security number or student ID number
- Applicant must possess a valid, active license from the State of Colorado as a Registered Nurse, Physician, Nurse Practitioner, Physician Assistant, Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Marriage & Family Therapist, Licensed Addiction Counselor or Certified Addiction Counselor III
- Applicant must have five years of full-time experience providing direct patient care as a Registered Nurse, Physician, Nurse Practitioner, Physician Assistant, Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Marriage & Family Therapist, Licensed Addiction Counselor or Certified Addiction Counselor III. This experience must have also included
- Advanced knowledge and a thorough understanding of health care delivery, standards of practice, quality improvement, and effective and accurate statistical analysis of quality of care
- Exceptional leadership and interpersonal skills with the ability to collaborate effectively across facility programs and with internal and external stakeholders
- Strong organizational skills with the ability to effectively manage all quality improvement activities within the CDOC Clinical Operations while ensuring healthcare measures are met
- Excellent written and verbal communication skills
- Ability to provide meticulous attention to detail
- Ability to provide analytical expertise in strategic planning, operational effectiveness and progressive evaluation of measurements
- Ability to provide expert testimony/evidence regarding the quality of care provided to offenders
- Ability to maintain extensive knowledge of current trends and legislation regarding the quality of healthcare
- Experience leading and managing a statewide quality management program for a correctional healthcare system to include the planning, designing, developing and revision of the program
- Current certification from a continuous quality improvement accreditation organization such as the Health Care Quality Certification Board or other similar accreditation agency. To ensure you meet this preferred qualification, please attach certification(s) to your application
- Extensive experience investigating, analyzing and reporting the quality of patient care outcomes
- Experience managing and providing oversight of a Quality Management Program
- Experience as a subject matter expert on continuous quality improvement processes in the healthcare industry
- Leadership experience in health care delivery, standards of practice, and quality improvement
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Manager Quality Improvement & Appeals Resume Examples & Samples
- Strategic design and implementation of Quality Improvement process and infrastructure, i.e. policies, procedures, workflows
- Oversees contractual quality improvement related deliverables for the program including but not limited to Program Description, Annual Quality Work Plan, and Annual Program Evaluation
- Designs and directs implementation methods for gathering and assessing customer service feedback
- Directs all quality training activities. Works closely with all areas to identify issues, implement corrective action, and improvement performance
- CPHQ or Six Sigma Green Belt required within two years of hire
- Ability to manage multiple projects and tasks
- 40-60 % travel required
129
Quality Improvement Care Coordinator Resume Examples & Samples
- Conducts telephonic outreach to members to support Quality Improvement, regulatory and contractual requirements
- Arranges transportation for members as needed
- Interacts with other departments including Customer Service to resolve member issues
- Completes special assignments and projects instrumental to the function of the department
- Preferred: Health coaching experience
- Knowledge of medical terminology and/or experience with CPT and ICD-9/10 coding
- Data entry skills
- Microsoft Word
- Microsoft Excel
- LI-JC1
130
Product Quality Improvement Engineer Resume Examples & Samples
- Design and/or improve processes for the manufacture of catalysts in order to reduce release time of batches and prevent failure reoccurrence, giving due consideration at all times to Quality standards, EHS and Sustainability
- Retrieve, collate and interpret complex technical and Quality data, for circulation and presentation to internal customers,
- Analyse data for integrity using known statistical methods. This could include trending and correlation of multiple data sources
- Plan and lead multi-departmental root cause analysis sessions; provide a plan of action and follow through the undertaking of actions via an action tracking system
- Coach the process support shift and NPI teams in structured problem solving and IPS methodology
- Coordinate appropriate resources to achieve specified objectives
- University education in a scientific or engineering discipline (chemical, process or similar) or equivalent experience
- Experience of slurry chemical batching, coating processes and heat treatment in a manufacturing environment would be an advantage
- Strong structured problem solving skills
- Good communication skills are required to work across a diverse range of functions
- Experience of Six Sigma Tools
- Understanding of Lean manufacturing practices and value stream mapping desired
- Knowledge Quality tools and Quality Management Systems ISO16949, ISO14001 and ISO18001 desired
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Quality Improvement RN Specialist Resume Examples & Samples
- Leads and/or facilitates clinical performance improvement teams/taskforce as indicated
- Serves as a team facilitator and consultative resource for clinical and departmental leadership and staff responsible for quality and performance improvement activities
- Promotes quality culture to population based multidisciplinary quality/performance improvement teams
- Supports and assists Quality Department management team in the implementation and monitoring of the Hospitals’ clinical quality improvement efforts. This may include concurrent oversight of Core Measure compliance
- Supports and maintains records, minutes, and data from population based quality committees, ad hoc PI teams, and other strategic quality initiatives in accordance with SJH confidentiality, and Federal and State regulatory guidelines
- Participates in regulatory activities and surveys, using working knowledge of CMS/Joint Commission, and Title 22 standards
- Attends medical staff committee meetings with punctuality (meetings may occur at varying frequency throughout the day, including early morning and late evening)
- Collaborates with Committee Chairs in developing meeting agendas and setting priorities and in leading improvement efforts related to Quality/Peer Review
132
Quality Improvement Project Manager Resume Examples & Samples
- Required A Master's Degree in a related field may be considered in lieu of experience
- Required 4+ years of experience in a health care delivery organization, such as a managed care organization or a hospital environment
- Preferred Licensed Registered Nurse (RN)
- Required Other Appropriate state licensure
133
Clinical Quality Improvement Mgr Resume Examples & Samples
- Provides leadership, in collaboration with the Director, in developing, planning, organizing, implementing and managing specified program development teams and/or projects in terms of overall system goals of clinical quality
- Co-develops and executes program strategies as a member of the leadership team
- RN or other clinical licensure
- Three years of clinical RN Experience
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Quality Improvement RN Resume Examples & Samples
- Knowledge and experience working with nationally established clinical quality guidelines and measurement sets such as HEDIS/NCQA or Joint Commission Standards for Accreditation
- Strong analytical skills, able to research, manipulate and interpret data
- Ability to measure, monitor, and track improvements in clinical care utilization
- Valid driver’s license and dependable transportation necessary
- Excellent public speaking skills
- Utilization management knowledge and experience
135
Administrative & Quality Improvement Section Manager Family Resume Examples & Samples
- An aptitude for supporting the implementation of new data and technology systems
- Strategic leadership skills to implement new initiatives and develop continuous quality improvement frameworks
- The ability to develop and implement strategies for measuring, reporting, and managing program performance standards and improve operations
- Experience in the application of change management practices and the ability to motivate and lead staff through the change process
- Effective interpersonal skills and the ability to work collaboratively with federal, state, and local programs, other Human Services divisions and County department staff, the community, and advisory groups
- The ability to manage and lead a section of staff providing administrative and quality improvement services
136
Quality & Improvement Engineer Defence Operations Resume Examples & Samples
- Drive compliance to MRO regulatory requirements (EASA 145, MAA MRP145, AS9100 and AS9110)
- Participate in Defence audit programme and act as a guide for external auditors
- MARS Coordinator within the Value Stream
- Complete MARS/MEDA investigations within the facility and complete investigations into issues and problems raised within the Value Stream using GP2.1 Manage Problems
- Liaise with the Containment Team to ensure non-conformance is managed as part of the 8D process
- Assess, receive and actively manage all non-conformance issues and customer returns through the SAP Quality Notification process to ensure closure within agreed timescales
- Liaise with Project Quality Engineer (PQE) role to drive engineering / process change where this is required for conformance and liaise with Project Quality Engineer (PQE) to support / lead end customer reviews
- Drive improvements within the Value Stream
- Develop internal processes to remove waste from the non-conformance management process
- Maintain visual management for all activities to clearly show activity and achievements
- Carry out surgery for non-conformance with containment team, Management of QNs, Non-conformance management including problem resolution, Management of customer returns resulting from supply-chain or build line non-conformance, Interfacing with PQE teams as required to ensure resolution of issues, Managing the customer returns Q-bond and resolving issues; interfacing with the PQE team where required
- Aerospace experience (preferred)
- Non-conformance management
- Problem Resolution Process training and capability
- 8D problem resolution process
- Root-Cause analysis
- Quality ethos in all activities
- Interpersonal and influencing skills
- Process audit and development
- Green Belt accredited beneficial
- Internal audit qualified (Lead Auditor preferred)
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Quality & Improvement Engineer Defence Operations Resume Examples & Samples
- Drive compliance to regulatory requirements
- Function support for Technical Review Committees
- Complete MARS/8D/QN investigations within the facility
- Complete investigations into issues and problems raised within the Value Stream using GP2.1 Manage Problems
- Liaise with the Containment Team to ensure non-conformance is managed via surgery and as part of the 8D process
- Managing the customer returns Q-bond and resolving issues; interfacing with the PQE team where required
- Internal audit qualified
138
Clinical Quality Improvement Stars Coordinator Resume Examples & Samples
- Complete claim research to identify the service performed, dates of service, provider type, and place of service. Research may include multiple systems and reports
- Participate in activities related to Quality Improvement HEDIS-STARS to identify and develop initiatives. Activities may include provider and/or member outreach via phone, fax or mail; obtain compliant data, as well as missing information related to medical record request. These activities may vary depending on the initiative or project and will include HEDIS – STARS workgroups and committees as assigned
- Maintain the SharePoint Site, update reports, change configuration and update the site as needed
- Provide support to assess and analyze available information from internal and external data, publicly available data, industry standards and other sources as needed and available. This support may include the reporting of CCIPs, QIPs and other regulatory requirements as needed
- Perform medical record reviews when necessary to support improvement and compliance, abstract HEDIS data, working collaboratively with the internal audit team
- Experience in or working knowledge of Quality Improvement Initiatives, HEDIS, Medicare STARS and Quality Rating Systems
- Deep understanding of health insurance industry, health care systems, and provider issues
- Knowledge of Compliance Standards and regulatory guidelines such as National Committee for Quality Assurance (NCQA), Center for Medicare/Medicaid Services (CMS)
- Advances understanding of medical terminology, abbreviations, body systems/anatomy, physiology and concepts of disease processes
