Quality Improvement Specialist (PARS)

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: The Quality Improvement Specialist for Physical Accessibility Review Survey (PARS) conducts on-site visits to individual Primary Care Physicians (PCP) sites, High Volume Specialists and Ancillary sites, and Hospitals to complete PARS audits/assessments and the documentation necessary to meet Department of Health Care (DHCS) Services regulatory requirements. The incumbent in this role also is responsible for managing provider data and developing reports documenting review outcomes.

• Conducts on site PARS audits/reviews with individual PCPs, High Volume Specialists and Ancillary sites, and Hospitals and documents findings using the DHCS assessment tool according to DHCS MMCD Policy Letter 12-006 or current requirement.

• Completes the PARS assessments; document results per Health Net Quality Improvement policies and procedures and regulatory requirements.

• Manages visit audit schedules.

• Uses data systems to record data, develops reports to be submitted to regulatory agencies, submit data for Health Net Web Portal and Provider Directory for PARS assessments, and develops outcome and trend reports for internal tracking.

• Coordinates and conducts both individual and group in-services for PCPs, PPG’s, internal Health Net associates, and departments providing detailed instruction and assistance for implementation of mechanisms to meet DHCS requirements.

• Provides technical assistance to PCPs, PPG’s, internal Health Net associates, and departments to improve accessibility for members.

• Participates in PARS trainings and departmental/Health Net meetings, Heath Net compliance learning to maintain knowledge and skills.

• Assists with departmental special projects, activities, and functions as requested by Manager.

• Provides professional courtesy, customer friendly services to contracted practitioners and office staff.

• Maintains confidentiality in compliance with HIPAA standards.
• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: Bachelor’s degree in health related field (Health Administration, Health Science, Epidemiology or Public Health etc.) or equivalent experience. Previous communications or business experience in a health related environment. One to two years experience in a provider or health care delivery setting.Two to three years experience in a managed care environment coordinating programs/seminars for providers. One to two years experience with computer applications and report writing.

Pay Range: $25.97 - $46.68 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act