Quality Improvement Specialist IV

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for underserved communities.

Best People, Best Solutions, Best Results

Job Summary:

Performs project management activities to help facilitate the successful implementation and completion of quality improvement projects in various delivery settings, coordinating project tasks and assignments with other QI team members. Conducts baseline analysis of current practices and utilizes quality improvement tools to identify opportunities for improving processes and procedures. Contributes to the maintenance and revision of quality-related policies and procedures, ensuring they are up-to-date with the latest healthcare regulations and best practices.

Essential Functions:

• Leads and manages complex quality improvement projects, coordinating tasks and assignments with QI team members. Oversees project implementation and completion, ensuring that all initiatives are executed effectively and meet predefined objectives. Conducts comprehensive baseline analyses and utilizes advanced quality improvement tools to identify and address process and procedural gaps.
• Maintains an advanced clinical knowledge of all assigned projects, managed care processes, and relevant regulatory issues. Ensures that project strategies and activities are informed by up-to-date and accurate information.
• Ensures timely completion of all contract deliverables, both internal and external. Monitors progress against deadlines and works proactively to address any issues that may impact the achievement of contract objectives.
• Updates and manages a comprehensive database of contacts at assigned facilities. Uses this database to facilitate communication, collaboration, and information sharing related to quality improvement initiatives.
• Coordinates and participates in meetings and committees as assigned, contributing expertise and providing presentations on quality improvement topics. Facilitates discussions and decisions to advance quality improvement goals.
• Engages with customers on-site and by phone to explain quality improvement initiatives, deliver training, and address issues. Acts as a key point of contact for resolving problems and ensuring that customer needs are met effectively.
• Prepares and maintains materials and information for providers involved in quality improvement initiatives. Ensures that all resources are accurate, current, and aligned with project objectives.
• Collaborates with the managed care team to plan and develop strategies that meet contract objectives. Monitors and documents the progress of assigned facilities, providing regular updates and recommendations for improvements.
• Adheres to contract-specific procedures and policies while conducting activities. Ensures compliance with all contractual requirements and organizational standards.

Level of Supervision Received:
Plans and arranges own work; works with manager to prioritize projects

Education (can be substituted for experience):
Minimum Bachelor's Degree required

Work Experience (can be substituted for education):
8 - 11 years of experience required; 12 - 14 years preferred

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.