Manager, Quality Improvement-Health Plan

Location:

Calmont Operations Building

Department:

Quality

Shift:

First Shift (United States of America)

Standard Weekly Hours:

40

Summary:

The Manager - Quality Improvement (“MQI”) oversees the Quality Improvement Program of Cook Children’s Health Plan (CCHP). The MQI is charged with staff guidance and supervision, state and regulatory quality compliance, HEDIS reporting activities, quality improvement initiatives, quality of care measurement and outcomes, policy and procedure development, and internal and external quality reviews.

The MQI is a leader and a subject matter expert in improving HEDIS performance and continuous quality improvement. The MQI regularly interacts with employees at all levels of CCHP and Cook Children’s Healthcare System in collaboration with CCHP members, providers and assigned vendors.

Additional Information:

The Manager - Quality Improvement (“MQI”) oversees the Quality Improvement Program of Cook Children’s Health Plan (CCHP). The MQI is charged with staff guidance and supervision, state and regulatory quality compliance, HEDIS reporting activities, quality improvement initiatives, quality of care measurement and outcomes, policy and procedure development, and internal and external quality reviews.

The MQI is a leader and a subject matter expert in improving HEDIS performance and continuous quality improvement. The MQI regularly interacts with employees at all levels of CCHP and Cook Children’s Healthcare System in collaboration with CCHP members, providers and assigned vendors.  
 

Qualifications:

• Bachelor’s Degree in a related field from an accredited college or university required.Bachelor’s Degree in Nursing is preferred.

• 4 years’ experience working with Medicaid, quality improvement, risk management, or care management, including at least 1 year of management experience is required.

Knowledge Skills & Abilities:

• Proficient in HEDIS Project Management, coordination, and data collection.

• Administration and Management — Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership techniques, production methods, and coordination of people and resources. 

• Business Acumen - the ability to understand and deal with various business situations in a way that is likely to lead to a positive outcome, seeing the bigger picture, anticipating challenges, and identifying opportunities for growth and improvement. 

• Coaching and Developing Others — Identifying the developmental needs of others and coaching, mentoring, or otherwise helping others to improve their knowledge or skills. 

• Communicating — Communicating effectively orally and in writing as appropriate for the needs of the audience, expressing or exchanging ideas through verbal communications. 

• Medical Principles - Knowledge of and ability to apply professional medical principles, procedures, and techniques.

• Technology - Demonstrated proficiency with technology platforms, for example, Microsoft Office Suite (Excel, Word, PowerPoint). 

Licensure, Registration, and/or Certification

• Certified Professional in Healthcare Quality (CPHQ) required.

About Us:

Cook Children's Health Plan

Cook Children's Health Plan provides vital coverage to nearly 120,000 people in low-income families who qualify for government-sponsored programs in our six county service region.  Cook Children's Health Plan provides health coverage for CHIP, CHIP Perinatal, STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant, Johnson, Denton, Parker, Hood and Wise.

Cook Children’s is an equal opportunity employer. As such, Cook Children’s offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.