Senior QI Specialist

Virginia, United States Minor Outlying Islands

Remote position available

Job Description

Serves as a member of the quality team at the national, regional or unit level. Coordinates projects resulting in continuous quality improvement and process improvement. Supports the maintenance of a strong quality program, measured processes including HEDIS (where applicable) and reported outcomes.

Essential Functions

- Serves as QI specialist for the quality program with the goal to meet customer requirements and performance guarantees. Duties include coordinating Quality/ Accreditation/Delegated initiatives and project plans, monitoring and execution to meet timely deliverables.
- Provides direct interventions with members and providers to address gaps in care.
- Develops, in collaboration with the customer and communication department, informational and training materials for providers and members.
- Coordinates with any vendors outreach and interventions.
- Prepares status reports on activities and outcomes of interventions and activities.
- Consults and trains staff on measurement specifications.
- Provide assistance as needed in data maximization efforts through coordination with the company's Central HEDIS team.
- Coordinates CQI (continuous quality improvement) processes and studies related to improved outcomes.
- Provides interface with customers, National Quality/Clinical and CCOE staff for HEDIS planning, reporting and program enhancements.

Preferred Qualifications:
Extensive experience in Quality, Accreditation, and Compliance Oversight.

General Job Information


Senior QI Specialist



Job Family

Quality Group


United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date


Date Requisition Created


Minimum Qualifications


Bachelors (Required)

License and Certifications - Required

License and Certifications - Preferred

RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

Other Job Requirements


Knowledge of HEDIS/meaurement specifications, accreditation standards and quality improvement processes. -Attention to detail and able to work efficiently to meet deadlines and timelines. -High degree of organization required. -Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports.

Expertise in data management, data analysis, reporting word processing, and project management skills

3-5 years quality improvement/HEDIS related experience

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

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