Supports the quality improvement department with annual medical record review activities including HEDIS, and Clinical Practice Guidelines by working collaboratively with the Quality Improvement Department.
December 17, 2022
Works in collaboration with various Health Plan departments, network providers, outside organizations to ensure regulatory requirements and time frames are met in processing member clinical grievances and QI Occurrences.
January 14, 2023
Maintains expert knowledge of information affecting clinical outcomes programs, clinical disease management, information systems, and PC data management.
February 16, 2023
Develops a calendar for monitoring quality indicators/quality check (QC) and provides routine reporting of variances to the appropriate Clinical Quality Assurance (CQA) staff and operational leadership.
March 25, 2023
Lead effective project teams and manage relationships with local quality champions and provide ongoing support in implementation efforts through coaching calls, webinars, one-on-one advising, implementation trainings, and remote methods.
April 15, 2023