The MAHQ offers free job posting for active members who have a vacancy in their organization. Other interested parties can contact Monica Cooke, MAHQ President at http://mahq.president@gmail.com for information related to job opportunity postings.

 Current Job Opportunities: 2 Listing(s)

 

 
Posted April 19, 2017
 
 

Quality Improvement Specialist (LPN) 
University of Maryland Medical System Health Plans - Timonium, MD

 

The Quality Specialist follows established preventive and disease management programs for health promotion and education. This position delivers culturally appropriate information regarding the availability of health and community resources that will reduce barriers to care.

Essential Duties and Responsibilities

  • Curriculum and planning for member and provider health education activities
  • Manage the UMMS Health Plans' Outreach Plan to assist enrollees in overcoming barriers in accessing health care services.
  • Identify the populations in need of education and outreach and make modifications as appropriate.
  • Promote health, wellness, prevention, and Community Health
  • Collaborate with educational and outreach efforts that includes case management, disease management, PCP referral for a one-on-one intervention for the member with complex medical needs, the home bound, and the noncompliant member with health issues.
  • Facilitate access to care
  • Manage difficult to reach and non-compliant members
  • Communicate member issues requiring interventions to appropriate departments and providers
  • Develop and maintain a report system, updating tracking logs, for outcomes that includes accurate data pertaining to the member’s health needs
  • Organize, collect, and create quantitative/qualitative analysis reporting to internal works groups, quality committees, network providers, and community liaisons.
  • Collect and report health and social information while demonstrating multicultural sensitivity and effective communication skills with Medicaid members
  • Adhere to regulatory and accreditation support
  • Perform other duties as assigned

*
Education, Experience and Qualifications

  • Licensed Practical Nurse
  • Associates, Bachelor’s degree in a related field or designation from the Academy of Healthcare Management (AHM)
  • Strong electronic, written, and verbal communication skills
  • Ability to work flex hours, including an occasional evening and weekend
  • Possess a valid Maryland State driver’s license

Strongly preferred:

  • 2+ years of experience in managed care, community, human services, nursing, and/or other health care settings.
  • Experience working with diverse populations, community or faith based organizations
  • Bilingual (English / Spanish)

Knowledge, Skills and Abilities

  • Knowledge of health education, motivational strategies, and an empathetic manner working with the underserved.
  • Knowledge of Maryland Medicaid healthcare business preferred.
  • Excellent verbal and written communication skills, including conflict resolution skills.
  • Strong organizational and follow up skills; specifically working with Inner City, Suburban and Rural neighborhood members.
  • Ability to collect and report outcomes verbally and in writing.
  • Ability to maintain confidentiality and assume accountability.
  • Proven ability to work in a self-directed manner, off-site with minimum supervision or field support
  • Instructional methods in Health Education and Outreach
  • Organization, Implementation and Management of Health Education and Outreach Programs
  • Measurement and Evaluation Curriculum and Planning for member and provider outreach and health education
  • Chronic and communicable Disease
  • Organizational Communications
  • Ability to meet deadlines in a consistent manner
  • Strong written and verbal skills
  • Knowledge of Medicaid and Medicare benefits desirable

Computer Skills

  • Microsoft Office skills to include Word, Excel, Access, PowerPoint, Project and SharePoint
  • Familiar with data entry systems (e.g., electronic medical records/electronic health records)

Job Type: Full-time

Required experience:

  • Medicaid: 1 year
  • managed care: 2 years

Required license or certification:

  • LPN

Send your resume to: jrobles@ummshealthplans.com to apply today.


Posted April 19, 2017

Quality Improvement Project Manager 
University of Maryland Medical System Health Plans - Timonium, MD

 

The Quality Improvement Project Manager is responsible for coordinating the Quality Improvement Committee and workgroups; and the development and implementation of the quality improvement program description, evaluation and the annual work plan. This is a high profile position that involves working with department and committee leaders to facilitate the development, monitoring and analysis of meaningful quality indicators, both clinical and non-clinical. The position facilitates and leads quality improvement initiatives and coordinates evidence of performance improvement and/or compliance with accrediting body (NCQA) and regulatory standards The Quality Improvement Coordinator serves as an internal consultant to department and quality committee leaders regarding quality improvement processes and regulatory/accrediting body standards; and facilitates relevant and meaningful indicator development and reporting within the quality committee structure.

Essential Duties and Responsibilities:

  • Coordinates and monitors the activities and results of surveys conducted for various purposes, including the CMS required Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Medicare's Health Outcome Survey (HOS), and required member Health Risk Assessments (HRAs) for Health Hierarchal Conditions (HCC).
  • Develops and oversees the monitoring and evaluation of Chronic Care Improvement Projects (CCIPs) Quality Improvement Projects (QIPs) and Performance Improvement Projects (PIPs).
  • Collects and analyzes data to identify opportunities for improvement and coordinates the development of action plans.
  • Enters / uploads accurate and timely data to the Health Plan Management System (HPMS), IDSS, ISS and EQRO systems.
  • Prepares the annual quality improvement program description, evaluation and work plan.
  • Leads, assists, and participates in various QI committees and workgroups to improve process and/or health outcomes.
  • Ensures QI committees and subcommittee agendas include all relevant and required items to meet NCQA and EQRO standards. Facilitates meeting progression and follow-up activities to ensure resolution of issues are documented. Annotates meeting documentation for NCQA and EQRO.
  • Assists in the development, monitoring and reporting of key metrics to evaluate the D-SNP Model of Care.
  • Assists in preparing and providing input into organizational policies and procedures.
  • Manages and displays clinical and non-clinical data to facilitate the identification of trends, patterns and opportunities for improvement, and evaluates outcomes of interventions.
  • Works collaboratively with others in Quality Management, Health Services and Clinical Support teams to promote quality and meet performance objectives.
  • Develops and maintains project plans to coordinate, implement and evaluate improvement initiatives.
  • At least annually conducts and evaluation of all QI related metrics and makes recommendations regarding additions, deletions and revisions.
  • Escalates project risks to QI leadership with supporting details.
  • Serves as a subject matter expert and internal resource on various quality standards, requirements and regulations.*
  • Designs quality improvement studies, audit tools, and other resources to measure the need for and impact of interventions. Summarizes results of studies into qualitative and quantitative data that is meaningful and makes recommendations for plan revisions, interventions and action plans.*

Education, Experience and Qualifications:

  • Baccalaureate degree in a related field required.
  • Current, active fully-licensed Maryland Registered Nurse or RN preferred.
  • Minimum of 3 years of clinical/healthcare experience and 2 years performance improvement or quality management activities required.
  • Project management experience required.
  • Data analytics and reporting experience required.
  • Experience working with Managed Care and/or Medicare or Medicaid.
  • Ability to work flex hours, including an occasional evening and weekend

Knowledge, Skills and Abilities

  • Detail-oriented with excellent verbal and written communications.
  • Excellent analytical and documentation skills.
  • Knowledge of Maryland Medicaid healthcare business preferred.
  • Knowledge of Medicaid and Medicare benefits desirable.
  • Excellent verbal and written communication skills, including conflict resolution skills.
  • Strong organizational skills to work on multiple projects simultaneously within established time frames.
  • Ability to create reports and present data and to staff, peers, providers and committees
  • Ability to collect and report outcomes verbally and in writing.
  • Business level math, basic statistical analysis.
  • Ability to maintain confidentiality and assume accountability.
  • Proven ability to work in a self-directed manner with minimum supervision.
  • Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
  • Ability to meet deadlines in a consistent manner.
  • Must work well with physicians, patients, caregivers and all other health care team members.
  • Reliable transportation, auto insurance and valid driver's license.

Computer Skills

  • Strong computer skills including use of various clinical and Microsoft applications, electronic medical records and scanning devices required.
  • Microsoft Office skills to include Word, Excel, Access, PowerPoint, Project and SharePoint
  • Familiar with data entry systems (e.g., electronic medical records/electronic health records)
  • Visio and flow charting software preferred

Job Type: Full-time

Required education:

  • Bachelor's

Required experience:

  • clinical/healthcare: 3 years

Send your resume to: jrobles@ummshealthplans.com to apply today.

If you have any questions about MAHQ or edits to this site, please contact Stephanie Potocki, Webmaster, stephpotocki6@gmail.com