Job Summary:
The Performance Improvement Evaluator III leads, implements, and evaluates performance improvement and population health processes through the integration of quality improvement science.
Essential Functions:
- Serve as the market professional expert for program evaluation, study designs, and methodological techniques
- Support market Quality Director to conduct assessments using qualitative and quantitative methodologies and continuous improvement tools to identify issues and opportunities to improve health outcomes
- Contribute to the development, implementation and monitoring of action plans based on performance metrics (State Agencies, AHRQ, HEDIS, CAHPS)
- Support the market Quality Director and market business owners in developing and monitoring Performance Improvement Projects (PIPs)
- Develop quarterly and annual quality data analysis reports
- Use statistical techniques, graphics and data to summarize HEDIS analytical needs to measure impact of various actions/results
- Monitor and provide reports regarding, process of provider profiling, focus groups and stakeholder interviews
- Identify opportunities for improvement in performance measure and survey scores based on evidence-based, results of quantitative and qualitative analysis
- Assist in the development of focus studies using epidemiological methodology to target population for interventions
- Conduct assessments to identify issues and opportunities using qualitative and quantitative methodologies and continuous improvement tools to improve health outcomes
- Contribute to the development of surveys, evaluation designs and facilitation guides
- Conduct process and gap analysis to diagnose process improvement opportunities and to develop re-usable solutions using principles of process excellence and related tools
- Explore best practices across various industries to bring to the work team
- Perform any other job related instructions, as requested
Education and Experience:
- Master of public health or related field degree (e.g. health promotion, evaluation etc.) is required
- Minimum of five (5) years of relevant work experience in program evaluation is required
- Experience using the model for improvement (PDSA-Plan, Do, Study, Act) is required
- Education or work experience in maternal and child health or chronic conditions is preferred
- Previous healthcare or managed care experience is preferred
Competencies, Knowledge and Skills:
- Proficient in Microsoft Word, Access and advanced proficiency in Excel is required
- Knowledge of a variety of quality improvement methodologies – Model for Improvement, Lean, Six Sigma
- Knowledge of establishing and documenting PDSA cycles and key driver diagrams
- Analytic skills for solving problems
- Knowledge of managed care and health care data coding is preferred
- Graphic development/presentation skills
- Familiar with descriptive statistical application and techniques
- Critical listening, thinking skills, and verbal and written communication skills
- Problem solving skills
- Excellent writing skills
Licensure and Certification:
- None
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$70,800.00 - $113,200.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
SalaryOrganization Level Competencies
Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
Top Skills
What We Do
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits.
CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve.
CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf
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