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This job was posted by https://idahoworks.gov : For more information, please see: https://idahoworks.gov/jobs/2338282 QUALITY CONSULTANT (HEALTHCARE)

Work from home (telecommute) within Oregon, Washington, Idaho or Utah

Build a career with purpose. Join our

Cause

to create a person-focused and economically sustainable health care system.

Who We Are Looking For:

Every day, Cambia\'s Payment Integrity - Clinical Quality Data Team is living our mission to make health care easier and lives better. The Quality Consultant develops and implements quality improvement programs related to clinical quality measurement and outcomes and assists in resolving deficiencies that impact plan compliance to regulatory accreditation standards and/or quality measurement. Ensures activities meet regulatory requirements of the state or product and reflects Cambia\'s quality strategies, approaches and work plans. - all in service of making our members\' health journeys easier.

If you\'re a motivated and experienced Healthcare Quality Data Professional looking to make a difference in the healthcare industry, apply for this exciting opportunity today!

Preferred Key Experience:

• Medical Record Review (Extraction)
• HEDIS (Preferred not required)
• EMR experience preferred
• Clinical background (RN or Coding)

What You Bring to Cambia:

Qualifications and Certifications:

• Quality Consultant would have a bachelor\'s degree in business administration or related field
• 6 years of progressive experience in health care administration, quality, project management or project support
• Or equivalent combination of education and experience.

Skills and Attributes (Not limited to):

• Knowledge of quality improvement processes and performance measurement and ability to develop and accomplish clinical quality measurement and/or program activities.
• Demonstrated ability to identify problems, develop solutions and implement a chosen course of action.
• Leadership skills with the ability to direct activities of others both individually and within a project team .
• Ability to organize, plan, prioritize and develop multiple projects within time constraints.
• Strong knowledge and understanding of data integrity/validity standards and significance.
• Ability to perform sound basic quantitative and qualitative analyses and interpretation.
• Knowledge of the healthcare industry, preferably in the managed care market.
• Excellent verbal and written communication skills including ability to communicate effectively across multiple areas and levels.
• Participation in successful NCQA/URAC accreditation process, AND/OR full HEDIS production reporting and continuous process improvement experience preferred.

What You Will Do at Cambia (Not limited to):

• Develops and maintains required/applicable quality program documents, including a standardized quality management plan and program to ensure compliance with external regulatory and accreditation and/or performance measurement requirements.
• Serves as a point of contact, coordinating and collaborating with accreditation entities and business partners to ensure compliance with accreditation and/or performance measurement requirements. Prepares enterprise for accreditation and/or performance measurement submissions and reviews.
• Serves as the subject matter expert for applicable accreditation standards/measurement requirements. Makes recommendations to business unit partners for improvements or remediation to accreditation/reporting compliance/improvement programs.
• Monitors exposure to accreditation/measurement risks and identifies opportunities to manage and mitigate those risks.
• Compiles information related to quality improvement and a creditation monitoring activities for internal use and external audits and maintains relevant records.
• Assists with the development and maintenance of required quality program documents. Responsible for reporting activities to the quality committee and management.

The expected hiring range for the Quality Consultant is \$80k-\$90k, depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this position is \$78k Low/ \$98k MRP / \$128k High

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we\'re helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join