JOB REQUIREMENTS: Overview Quality Initiatives Specialist, MercyCareInsurance, Days, 80 Hrs/2 wks Location: MercyCare Bldg, Janesville, WI.Hybrid schedule avaliable after training period. The MCIC QualityInitiatives Specialist is responsible for planning and conductingactivities concerned with the quality improvement of behavioral andmedical health initiatives for MercyCare Health Plan members andproviders. To this end, this position will analyze, review, forecast,trend, and present information relating to clinical quality measurespresented by NCQA, HEDIS, and other state and federal regulations. TheMCIC Quality Initiatives Specialist 3 will use that information invarious quality improvement projects resulting in member and provideroutreach and referrals to disease and case management. Perform otherduties as assigned. Responsibilities Acts as a lead specialist toprovide project, program and /or initiative-related direction andguidance for other specialists within the department and/orcollaboratively with other departments. Assists in monitoring andanalyzing outcomes to ensure goals, objectives, outcomes, accreditationand regulatory requirements are met. Program and support MicrosoftAccess databases to manage targeted disease populations and provideefficiencies in work processes. Design and implement strategies foroutcomes improvement based on membership population characteristics andbusiness functions requirements. Participate in the implementation ofContinuous Quality Improvement activities by contributing front lineknowledge of projects and observations. Develop optimal alternativesolutions based on feedback and environmental analysis. Implementprocess improvement using innovative thinking, root-cause-analysis,process mapping, and charting techniques. Complete Quality Initiativeprojects according to specifications and requirements. This includes:Following project policies and procedures. Accurate audit of measures.Data management: interfacing with and utilizing various software andportals for auditing and submitting data. Writing and updating policiesand procedures. Provide follow up and education of providers and clinicstaff on measures and project objectives.HEDIS / Quality ReportingPerforms the lead role in the coordination and preparation of the HEDISmedical record review which includes ongoing review of records submittedby providers and the annual HEDIS medical record review Assists Managerin training and takes the lead role in these activitiesAbstract datafrom the medical records and loads data into the HEDIS application, andcompares the documentation in the medical record to specifications todetermine if preventive and diagnostic services have been correctlyperformed. Works with the corporate HEDIS team to monitor accuracyof... For full info follow application link. EOE&AA/M/F/Vet/Disabled.Mercy is an equal employment opportunity employer functioning underAffirmative Action Plans. ***** APPLICATION INSTRUCTIONS: ApplyOnline: ipc.us/t/A037B53EE9E44AFE