Description:
• Review/Analyze reports for supporting improvements in member experience outcomes.
• Monitor key metrics to measure the business and improve operating processes.
• Complete assigned audits – calls or PGs for Specialty Pharmacy and records in the appropriate database.
• Collects and analyzes data related to healthcare quality measures, patient outcomes, and key performance indicators.
• Contributes to the implementation and maintenance of quality assurance programs in compliance with regulatory requirements and industry standards.
• Assists in the development and review of quality protocols, policies, and procedures.
• Compiles and maintains records of quality metrics, performance indicators, and improvement initiatives.
• Conducts basic audits and assessments to evaluate adherence to quality standards and identify areas for improvement.
• Communicates quality goals, strategies, and progress internally through meetings, presentations, and regular updates.
• Coordinates with cross-functional teams to develop and implement comprehensive quality improvement projects and programs.
• Carries out quality improvement initiatives aimed at enhancing healthcare processes, patient safety, and clinical outcomes.
• Assists in providing education and guidance to staff members on quality standards, regulatory requirements, and performance improvement methodologies.
Requirements:
• 1+ years of SPRx
• 2+ years of Data interpretation and analysis experience
• Adept at problem solving and decision-making skills
• Basic awareness of problem solving and decision-making skills
• Microsoft Excel, Word, PowerPoint
• Program application such as Mattersight and ProNet
• Quality Improvement Associate Certification (CQIA) preferred
Benefits:
• Affordable medical plan options,
• a 401(k) plan (including matching company contributions),
• and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings,
• tobacco cessation and weight management programs,
• confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off,
• flexible work schedules,
• family leave,
• dependent care resources,
• colleague assistance programs,
• tuition assistance,
• retiree medical access and many other benefits depending on eligibility.
If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.
Subscribe to Rise newsletter