Quality Specialist - Medicaid Care Management - ECU Health

ECU Health

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children’s Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

Position Summary

• The Quality Specialist coordinates the development and implementation of quality projects, programs and initiatives.

Responsibilities

• Coordinates the development, implementation and outcomes of quality projects, programs and initiatives. 
• Understands the quality vision and mission, and communicates that vision and mission throughout the organization. 
• Provides quality improvement expertise in assessing, evaluating and monitoring improvement strategies. 
• Develops and refines, in collaboration with clinical and medical leadership, action plan for quality improvement.  
• Assists key service and priority areas with the development and annual review of operational QI plans, including measures of success. 
• Maintains close familiarity with the flow of care, staffing issues, documentation, inter and intradepartmental issues across the organization. 
• Provides education, coordination and guidance to QI committees and activities to adequately apply all available legal  protections of quality data, discussions and activities. 
• Coordinates collection, validation and submission of quality data to outside agencies. 
• Assesses and applies the appropriate quality tool to achieve desired outcomes. 
• Monitors action plans to achieve targeted outcomes. 
• Incorporates evidenced based research and best practice
• Communicates effectively throughout all organization to achieve quality outcomes. 
• Functions as effective change agent to achieve desired quality outcomes and to ensure progress of quality initiatives. 
• Establish productive relationships throughout organization. 
• Maintains excellent written and verbal communications stakeholders. 
• Mentors staff to be active participants in quality and change processes.
• Supports efforts to comply with accrediting and regulatory agencies. 
• Monitors compliance with JCAHO , licensing bodies, and other accrediting standards. 
• Stays abreast of changes in standards/criteria and communicates same throughout organization. 
• Works with departments/services/priorities to become compliant as issues arise. 
• Assists as requested in supporting medical center site visits and prepares required document.
• Serves as resource/consultant. 
• Consults with quality peers throughout the state. 
• Actively participates in appropriate local, state, and national quality organizations.
• Contributes to educational programs
• Communicates with the appropriate dept to ensure dissemination of quality improvement information. 
• Provides expertise for planned, systematic and just in time education on appropriate quality tools and related topics. 
• Participates in educational conferences. 
• Uses teaching/learning theories and principles to foster the educational development of others.  Adjusts presentation style and materials to meet the needs/expertise of the audience.
• Within 3 years of initial employment in the department has obtained and/or maintained appropriate quality certification.
• Maintains confidentiality of medical records and complies with all applicable state and federal regulations, including, but not limited to, HIPAA and HITECH

Minimum Requirements

• BS required. 
• Allied Health, Business, Public Health, Computer Sciences with a concentration in healthcare or comparable. 
• 2 to 3 years experience in leadership, quality representative or management role required.

General Statement

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.