Quality Analyst of Care Coordination Programs - Sr

Company Name:
Title: Quality Analyst of Care Coordination Programs - Sr
Location: null
Other Locations: null
What you''ll get to do:
The Senior Quality Program Analyst will support activities related to meeting regulatory quality compliance requirements in the Center for Healthy Aging and State Public Programs. Regulatory requirements are established by the Centers for Medicare and Medicaid Services (CMS), the Minnesota Department of Human Services (DHS), the Minnesota Department of Health (MDH), and the National Committee for Quality Assurance (NCQA). Duties include the following:
Represent the Medica and/or the Regulatory Quality team on assigned workgroups, committees, and projects, internal and external, as assigned by the Regulatory Quality manager
Provide project management for administrative and clinical projects/activities; participate in interdepartmental projects and committees. Works internally with Medica''s Quality Improvement, Care Management, Compliance, and other areas
Establish and maintain effective professional relationships with external organizations such as DHS, Medica''s contracted delegates care systems, counties, and agencies , clinics, and hospitals
Lead the development of compliance activities to meet new contractual, state and federal requirements required for members in Medicare Advantage products, Special Needs Plan products, and State Public Programs Products
Lead projects such as: audits of compliance with DHS contracts and protocols across the contracted network, collection and analysis of data for audits such as the NCQA Structure and Process audit, data collection and analysis for Part C Assessment and Reassessment Reporting, and collaboration with clinical quality disease management programs including Health Coaching
Utilize communication skills, both oral and written, that are essential to managing projects, communication of regulatory and contractual requirements, documenting projects, and producing reports which fulfill regulatory requirements
Key Accountabilities:
Project Management: including research, development, implementation, evaluation, and reporting to leadership and others
Program Audit, Training and Regulatory Support
Build and maintain successful professional relationships with key parties
Bachelor''s degree or equivalent combination of education and health care work experience
4 years health care work experience; Care Coordination experience preferred
Specific types of experience:
Knowledge of Medicare and Medicaid quality requirements preferred
Compliance and/or Quality improvement experience preferred
Clinical experience (RN, LPN), Social Work, or Master's in Public Health preferred
Project management
Skills and Abilities:
Ability to work with minimal supervision
Computer experience (moderate) using Microsoft Word, Excel, PowerPoint, Visio, and basic experience with Access
Data collection and analysis - experience with data collection tool design, data entry, and data displays
Ability to locate, read, and interpret statutes and regulations related to quality requirements
Project management experience: including research, proposal development, implementation, and evaluation
Travel Requirements specific to this role:
Position requires candidates have an ability to travel up to 75% in the state of Minnesota. Travel at this rate is anticipated annually in the months of April, May, June and July.
Travel is required during the balance of the year at approximately 25-30% on a consistent weekly basis
Equal Opportunity Employer including Veterans and Disabled Individuals
Thrive Together.
At Medica, you''ll enjoy working with talented people who share a mission to meet our customers'' needs.
Grow Together.
Medica will support you through your personal growth and involvement in the community.
Succeed Together.
Medica provides resources that allow you to take charge of your health and career.

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.