What are the responsibilities and job description for the Coordinator, Quality - Michigan position at Michigan - McLaren Careers?
McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Quality Coordinator, to join in leading the organization forward.
MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).
MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
Position Summary: Responsible for providing daily support to the Quality Leadership Team. Coordinates specific regulatory and contractual responsibilities as assigned, for the assigned Plan, including but not limited to Healthcare Effectiveness Data and Information Set (HEDIS), National Committee for Quality Assurance (NCQA), Consumer Assessment of Healthcare Providers and Systems (CAHPS), state standards, site audits, and state regulatory requirements.
Essential Functions and Responsibilities:
Coordinates the Healthcare Effectiveness Data Information Set (HEDIS) project plan to support a timely and accurate HEDIS submission and year-round tracking.
Directs and optimizes the organization's proactive and regulator data collection to improve performance on HEDIS and CAHPS surveys.
Collaborates with other departments in the development of data analysis strategies and reporting formats for HEDIS.
Coordinates adherence to all regulatory requirements and contractual responsibilities within the specific areas of responsibility for the Plan.
Assists leadership in leading the HEDIS process including the Roadmap, Hybrid Audit, Interactive Data Submission System (IDSS) submission and development of HYBRID tools.
Recommends the development and implementation of policies and procedures that support regulatory and contractual requirements.
Qualifications:
Required:
- Associate degree in business, health care, or related field, or; high school diploma with two (2) years of related experience.
Three (3) years’ experience and knowledge of HMO, PPO, TPA and Managed Care functions, including one (1) year performing quality management activities including HEDIS and CAHPS.
Preferred:
- Bachelor’s degree in business, health care, or related field.
Quality Management accreditation.
- One (1) year of experience working with the standards of an accrediting body such as NCQA.