Quality Compliance Professional
Job Description: • participate in performance and quality improvement projects by implementing member and provider targeted interventions. • contribute to multidisciplinary committees required by NCQA and the State Contract. • conduct member outreach calls and medical record audits for provider compliance. • perform provider outreach to close care gaps and audit records to identify improvement opportunities. • complete and update reports, including State Reports and Kentucky Medicaid Quality Improvement Committee reports. Requirements: • 3+ years of previous experience working with member outreach on quality and performance improvement activities. • 2+ years previous experience in healthcare quality improvement/quality operations. • Knowledge of HEDIS/CMS/Quality. • Experience with healthcare quality measures (example HEDIS, CAHPS). • Comprehensive knowledge of Microsoft Office Word, PowerPoint, intermediate Excel experience (pivot tables/filtering, charts, formulas). Benefits: • paid time off • 401(k) retirement savings plan • employee assistance program • business travel and accident Apply tot his job