Performance Improvement Evaluator III

Posted Yesterday
Be an Early Applicant
Hiring Remotely in USA
Remote
71K-113K Annually
Senior level
Healthtech • Insurance
The Role
The Performance Improvement Evaluator III leads performance improvement processes, evaluates health outcomes, and supports development of action plans based on performance metrics. The role involves qualitative and quantitative analysis, report generation, and identifying improvement opportunities.
Summary Generated by Built In

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 - $113,200.00

CareSource 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):

Salary

Organization Level Competencies

  • Create an Inclusive Environment

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business


 

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.#LI-JM1

Top Skills

Lean
Microsoft Access
Excel
Microsoft Word
Quality Improvement Methodologies
Six Sigma
Statistical Techniques
Am I A Good Fit?
beta
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company
HQ: Dayton, OH
3,668 Employees

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

Si usted o alguien a quien ayuda tienen preguntas sobre CareSource, tiene derecho a recibir esta información y ayuda en su propio idioma sin costo. Para hablar con un intérprete, Por favor, llame al número de Servicios para Afiliados que figura en su tarjeta de identificación.

如果您或者您在帮助的人对 CareSource 存有疑问,您有权 免费获得以您的语言提供的帮助和信息。 如果您需要与一 位翻译交谈,请拨打您的会员 ID 卡上的会员服务电话号码

Similar Jobs

Scrunch AI Logo Scrunch AI

Growth Marketer

Artificial Intelligence • Information Technology • Marketing Tech • Software • SEO
Remote
United States

Scrunch AI Logo Scrunch AI

GTM Engineer

Artificial Intelligence • Information Technology • Marketing Tech • Software • SEO
Remote
USA

Rula Logo Rula

Sr. Revenue Cycle Manager (Remote)

Healthtech • Other • Social Impact • Software • Telehealth
Remote
United States

Rula Logo Rula

Data Labeling Manager (Remote)

Healthtech • Other • Social Impact • Software • Telehealth
Remote
United States

Similar Companies Hiring

Axle Health Thumbnail
Logistics • Information Technology • Healthtech • Artificial Intelligence
Santa Monica, CA
17 Employees
Camber Thumbnail
Social Impact • Healthtech • Fintech
New York, NY
53 Employees
Sailor Health Thumbnail
Telehealth • Social Impact • Healthtech
New York City, NY
20 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account