Provider Quality Improvement Specialist

EWINGS is seeking Provider Quality Improvement Specialists who have worked for Quality Improvement Organizations (QIOs) and QIO-like entities on various CMS task orders.

The Quality Improvement Specialist is responsible for improving quality outcomes of practices, facilities, or hospitals by supporting the Centers for Medicare & Medicaid Services (CMS) Task Order goals, initiatives, and deliverables. As additional CMS Task Orders are awarded, the Quality Improvement Specialist will provide subject matter expertise for CMS goal achievement.

This position is remote based. C andidates located in the Eastern or Central time zones are strongly preferred. Candidates must be able to travel to local provider offices as needed.

In this role, the ideal candidate does the following :

Collaborates with multi-disciplinary team to develop and support QIP initiatives, projects, patients, documents, and tools for QIPs and assigned communities.

Collaborates with providers to develop data-driven quality improvement methodologies.

Responsible for timely interpretation and analysis of information provided to support contract compliance and quality improvement initiatives.

Provides technical assistance, support, and education to providers, practice managers, and other stakeholders to achieve the QIP initiative's goals.

Understands, assesses, and interprets data for quality improvement efforts.

Develop reports inclusive of findings and recommendations.

Tracks and monitors projects to ensure timely submittal or execution on contract deliverables and reports.

As additional CMS Task Orders are awarded, provide subject matter expertise for CMS goal achievement.

Other tasks and responsibilities as assigned.

Promotes core values of teamwork, professionalism, effective communication skills and positive attitude.

Maintains security and confidentiality of all information in accordance with HIPAA laws, URAC regulations, and company policies.

Performs other tasks and duties as assigned.

Knowledge, skills and abilities required for this role include :

Demonstrated experience in healthcare Quality Improvement (QI) and the ability to motivate and lead others to provide quality services and deliverables in a timely manner, with experience with improvement of HAIs in a healthcare setting is preferred.

Knowledge of quality improvement principles and practices (project management, patient safety concepts, peer review, public reporting, data analysis, data management, and statistical process control in healthcare.

Knowledge, skills, and experience with critical-thinking, innovation, and problem-solving, recommending successful solutions, including the spread and implementation of such solutions for large scale change.

Excellent oral and written communication spanning from executives to public.

Ability to handle multiple activities / projects simultaneously and meet deadlines.

Ability to interact with all levels of an organization with excellent interpersonal and team skills.

Computer literate with Intermediate-Advance knowledge of Microsoft Office, including Word, Outlook, PowerPoint, Excel and Teams and Edge, and Internet.

Ability to travel by driving or flying to Company locations, customer events or meetings or other locations as needed.

Required education, experience and training :

Bachelor’s degree in public health, nursing, or related healthcare field

Minimum - years of related experience

Preferred education, experience and training :

Certified Professional Healthcare Quality (CPHQ), or Certified Fraud Examiner, or CPQH Certification, or Patient Centered Medical Home (PCMH) certification, or Medical Records Coding, or Clinical Licensure.

Knowledge of URAC or NCQA accreditation standards and / or HEDIS certification a plus.

Knowledge of claims, credentialing, appeals & grievances a plus.