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Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com .

This position is a remote position with a strong preference for an Ohio resident. ;This position may be required to make provider visits within the state.

Responsibilities:

As part of the Quality Management team, the Quality Performance Specialist is responsible for the coordination and ongoing monitoring of QI program objectives, including the delivery of performance improvement projects for service and clinical activities, integrating the quality improvement plan into all departments and facilitating HEDIS, CAHPS and NCQA accreditation activities.; Implements and supports the overall implementation of quality programs that meet or exceed applicable State, Federal and NCQA standards.;;

Principal Accountabilities:

• Executes on organizational efforts in ongoing quality improvement processes to ensure compliance with State, Federal, regulatory and accrediting body’s standard requirements.

• Responsible for completion and analysis of annual HEDIS results and works with all areas to integrate results into departmental goals.;;

• Experience with PDSA (Plan-Do-Study Act) Cycle expertise preferred.; Understanding of rapid-cycle improvements.;

• Responsible for the successful development and evaluation of an annual QI work plan and program description by facilitating QI throughout the organization.;

• Identifies resolves and/or escalates problematic QI areas that may place plan at risk of not achieving annual goals.

• Collaborates with Provider Services and Member Services to complete analysis of annual satisfaction surveys and works with all areas to integrate results into departmental goals.

• Participates in the development, implementation and maintenance of QI policies and procedures.

• Serves as a resource to other departments in completing QI goals.;

• Works professionally and efficiently with all functional areas in meeting organizational and departmental quality goals.

• Participates on QI committees structured to achieve outcomes success and completes committee documentation that is consistent in meeting regulatory and accrediting body requirements.;

Education/ Experience:

• Associate’s Degree or equivalent work experience required, ;Bachelor’s Degree preferred.

• Minimum of 3 years in clinical or service quality improvement required.

• Minimum of 3 years in healthcare delivery required.;;

Other Skills:

• Managed Healthcare experience preferred.

• Successful management of NCQA accreditation survey preferred.

• Excellent organizational, analytical and interpersonal skills.

• Excellent written and verbal communication skills.

• Ability to work successfully within all levels of the organization.

• Ability to design, develop and implement projects to address financial, quality and service improvements.

• Proficient computer skills:; FMEA, fishbone, KDDs, Pareto charts, run/control charts, Gemba walks.;;

• IHI Model experience a plus.;;

Diversity, Equity, and Inclusion

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.