About Texas Children's HospitalFounded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.
We are searching for a Quality Improvement Specialist— someone with enthusiasm for leading process improvement! In this position, you will lead process improvement across the health plan to improve our performance on quality measures and improve operations to establish NCQA Accreditation. Responsibilities of this role are diverse and will expose you to various parts of the health plan and the Texas Children’s integrated delivery system.
Think you’ve got what it takes?
• Leads process improvement to meet assigned objectives defined by the Quality Improvement Program (QI Program)
• Directs and optimizes the organization’s proactive and regulatory data collection to improve performance on HEDIS and CAHPS surveys
• Coordinates and supports quality improvement committees and external advisory committees
• Manages process improvement at provider sites to support the provider’s performance on high-impact quality measures and adherence to clinical practice guidelines
• Runs provider audit activities to advise corrective action in response to complaints or concerns regarding a provider in the network
• Provides timely and accurate completion of any state reporting requirement for MCO quality reporting
• Conducts medical record reviews and abstracts needed information for annual HEDIS regulatory requirement
• Bachelor’s degree
• 1-year minimum of project management or process/quality improvement experience