Job Summary- Hybrid Work Environment - Must reside in Hawaii
Pay Range: $64,915 - $103,415
Note: Individuals typically begin between the minimum to middle of the pay range.
Develop member and provider interventions to improve clinical quality and member experience. Coordinate efforts with HMSA's vendor partners, community resources, and internal departments to achieve excellent results in health plan ratings and pay-for-performance programs. Complete project planning, implementation and management, including independent research, analysis and communication efforts, to support multiple cross-departmental programs and related projects.
Minimum Qualifications- Bachelor's degree and four years of related work experience; or equivalent combination of education and related work experience.
- Strong interpersonal skills; Excellent verbal and written communication skills.
- Knowledge of basic relevant statistical analyses.
- Proficiency in issues identification and data collection, analysis, and interpretation.
- Basic working knowledge of Microsoft Outlook and PowerPoint.
- Intermediate working knowledge of Microsoft Word.
- Advanced knowledge of Microsoft Excel.
Duties and Responsibilities- Quality Improvement Interventions Analysis and Development:
- Work as part of a quality team to continuously identify, plan, develop, implement, and evaluate interventions.
- Develop reports, analyses, and data mining to support program planning and interventions.
- Complete program and initiative evaluations such as return on investment and health outcomes.
- Apply detailed analysis and problem solving to research and recognize trends to assess need and identify opportunities for quality improvement.
- Gather and synthesize research studies, industry information, and BCBSA resources to gain insight and apply best practices to health care quality improvement strategies.
- Conduct data analysis to support projects and interventions, including gathering data, analyzing data, and presenting recommendations.
- Program and Project Management:
- Plan and implement multiple cross-departmental programs and project(s) with guidance from program managers, executive sponsors, subject matter experts, and project staff.
- Define project scope and schedule by working with business area leads and develop project plans; including tasks, deliverables, and expected outcomes/goals.
- Develop and facilitate full project documentation and reporting to meet identified goals and objectives of each project.
- Proactively monitor overall project performance and life cycle (e.g., on time, within scope and with quality) against measure plans/dashboards and make adjustments as needed.
- Manage and track risks and issues to completion.
- Organize and lead project status and working meetings.
- Work directly with cross-departmental team members to facilitate communication. Prepare and provide status updates and reports to business owners, executive sponsors, partners, project teams, and others as required.
- Assist with tracking project expenses.
- Generate requirements, reports, and operational processes.
- Complete program and project evaluations, including accomplishments, outcomes, barriers, and opportunities.
- Cross-Functional Integration and Communication:
- Work with HMSA departments and external partners to collect and distribute information, complete tasks, facilitate communication, and provide status updates to ensure coordination among groups.
- Communicate analysis, assessments, recommendations and completed work product by creating and delivering reports and presentations to quality committees and other internal and external stakeholders.
- Quality Improvement Program Support:
- Complete work and documentation to support completion of activities for the annual Quality Improvement Evaluation and Workplan.
- Support completion of required reporting and quality improvement plans.
- Coordinate, facilitate and conduct medical record reviews to support quality activities.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
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