Site: Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.

We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

This role is collecting and reviewing NCQA documentation from stakeholders throughout MGB Health Plan. This person will be a resource about NCQA requirements to stakeholders throughout MGB Health Plan.

Job Summary:

The Quality Improvement Specialist plays a key role in ensuring that the department performs at the highest levels on standardized, national measures of clinical care quality and accreditation. Ensures the accurate and timely collection of data from clinical records, identifies opportunities for improvement, communicates and works collaboratively with multidisciplinary improvement teams and facilitates the creation and implementation of improvements in care processes.
Essential Functions
-Assist with the development and coordination of all documentation needed to successfully maintain NCQA accreditation.
-Support the development of quality improvement performance audit function processes and tools
-Assist in designing, running, managing, and data review process for assuring accuracy and integrity of health services data reports to meet regulatory and operational requirements
-Report outcomes and quality monitoring results to management
-Assist with managing databases, policies and procedures related to assigned areas
-Assist with related activities for various committees and meetings for assigned areas
-Support vendor/delegate oversight.
-Consults on quality issues and develops solutions

Qualifications:

Education

• Bachelor's Degree required; experience can be considered in lieu of education

Experience

• Experience in Quality Improvement, preferably in a healthcare setting 2-3 years required.
• NCQA Health Plan and/or Health Outcomes Accreditation experience highly preferred.

Knowledge, Skills, and Abilities

• Demonstrated knowledge and use of quality improvement methodologies and tools.
• Must have strong interpersonal skills necessary to establish supportive, collegial relationships, and to interact effectively with administrative and clinical leadership, staff, clinical leads, and other healthcare professionals.
• Ability to manage multiple projects simultaneously and adhere to work deadlines.
• Excellent verbal and written communication skills.
• Excellent computer skills including Microsoft Office (Word, Excel, PowerPoint, Access), Flowcharting/mapping (QI Charts).
• Ability to learn and effectively use computer software, such as electronic health records and data entry tools.

Additional Job Details (if applicable)

Working Conditions

• This is a remote role that can be done from most US states
• This role is Monday through Friday, business hours EST

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours:

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$63,648.00 - $90,750.40/Annual

Grade

6

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.