Your Future Evolves HereEvolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.Join Evolent for the mission. Stay for the culture.What You’ll Be Doing:Put your passion where it meets purpose! The Senior Quality Specialist will serve as a member of the quality team at the national, regional or unit level. The candidate selected will coordinate projects resulting in continuous quality improvement, process improvement and quality oversight with vendor management, delegation oversight activities and knowledgeable with NCQA and URAC standards as it relates to vendor oversight and Health Plan Delegation audits. The candidate will also support the maintenance of a strong quality program, measured processes including URAC, NCQA (where applicable) and reported outcomes.Collaboration Opportunities:
Lead assigned quality and process improvement activities which may include accreditation support, process improvement, projects, quality studies, CQI (continuous quality improvement) process training for staff, prevention program coordination, care coordination initiatives, satisfaction survey coordination and follow-up, provider and member advisory groups (where applicable), tracking of adverse incidents, monitoring of performance guarantees, CAPs and customer related quality initiatives
Knowledgeable and/or SME in Accreditation (NCQA and/or URAC) requirements (where applicable)
Provide or support direct interventions with members and providers to address gaps in care or compliance
Prepare status reports on activities and outcomes of interventions and activities
Provide consultation and training to staff on quality, accreditation, and core performance indicators measurement specifications
Assist as needed in data maximization efforts through coordination with the company's team
Lead CQI (continuous quality improvement) processes and studies related to improved outcomes
Interface with internal and external customers for accreditation (where applicable) planning, reporting and program enhancements
Responsible or support Quality Improvement Activities and established ROI
Able to work independently
Qualifications – Required and Preferred:
Bachelor’s degree or equivalent work experience (Required)
3-5+ years of quality improvement and auditing or related experience in healthcare field (Required)
Knowledge of healthcare quality improvement processes, accreditation standards, and performance measurement (Required)
Attention to detail and able to work efficiently to meet deadlines and timelines (Required)
High degree of organization (Required)
Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports (Required)
Expertise and proficient in data management, data analysis, reporting word processing, and project management skills (Required)
Independently develops, understands, and communicates the extrapolated data to stakeholders (Required)
Proficient knowledge of Microsoft Excel, and/or MS Project (Required)
CPHQ - Certified Professional in Healthcare Quality (Preferred)
Experience working independently & managing quality improvement activities resulting in Return on Investment (ROI) (Preferred)
Ability to take lead on projects and run meetings with stakeholders (Preferred)
Technical Requirements:We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact recruiting@evolent.com for further assistance.The expected base salary/wage range for this position is $68,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!For more insights about Evolent Health, click on Life At Evolent (https://www.evolent.com/) to learn more!
