Clinical Quality Specialist - Peak Health (Remote)

Role Overview

The Clinical Quality Specialist at WVU Medicine's Peak Health plays a crucial role in ensuring the highest standards of healthcare quality and regulatory compliance. This remote position offers an exciting opportunity to contribute to performance improvement initiatives, work with providers to enhance documentation accuracy, and collaborate with a dedicated team to achieve HEDIS program goals. As a Clinical Quality Specialist, you will be responsible for monitoring and assessing performance, gathering and analyzing data, and identifying areas for improvement within the organization.

Day in the Life

A typical day for a Clinical Quality Specialist might involve:

• Analyzing HEDIS compliance rates and identifying trends.
• Reviewing medical records to ensure quality care is being provided.
• Collaborating with providers to improve documentation accuracy.
• Participating in performance improvement projects (PIPs).
• Preparing reports on quality improvement activities.
• Investigating potential quality of care issues.
• Ensuring compliance with regulatory and accreditation standards.
• Working with large datasets to analyze information and provide recommendations.
• Contributing to the development and implementation of quality improvement plans.
• Attending meetings and training sessions to stay updated on industry best practices.

Why Remote at WVU Medicine Peak Health

Working remotely as a Clinical Quality Specialist at WVU Medicine Peak Health offers numerous advantages:

• Flexibility: Enjoy a better work-life balance with the ability to manage your schedule and work from the comfort of your home.
• Reduced Commute: Save time and money by eliminating the daily commute.
• Increased Productivity: Create a personalized workspace that promotes focus and efficiency.
• Collaboration: Stay connected with your team through virtual meetings and communication tools.
• Impact: Contribute to improving healthcare quality across the WVU Medicine network from anywhere.

Career Path

The Clinical Quality Specialist role can be a stepping stone to various career paths within WVU Medicine, including:

• Quality Manager: Oversee quality improvement initiatives and ensure compliance with regulatory standards.
• HEDIS Program Manager: Lead the HEDIS program and collaborate with providers to improve HEDIS compliance rates.
• Clinical Informatics Specialist: Utilize data and technology to improve healthcare outcomes.
• Compliance Officer: Ensure that the organization adheres to all applicable laws and regulations.
• Healthcare Consultant: Provide expert advice to healthcare organizations on quality improvement and regulatory compliance.

Salary & Benefits

The estimated salary range for a Clinical Quality Specialist at WVU Medicine is $65,000 to $95,000 per year. WVU Medicine offers a comprehensive benefits package, including:

• Comprehensive health insurance (medical, dental, vision)
• Paid time off (PTO) for vacation, sick leave, and holidays
• Retirement plan with employer matching contributions
• Life insurance and disability coverage
• Flexible spending accounts (FSAs) or health savings accounts (HSAs)
• Employee assistance program (EAP) for confidential counseling and support
• Wellness programs and resources to promote employee health and well-being
• Tuition reimbursement or assistance for continuing education
• Professional development opportunities for career advancement
• Employee discounts on various products and services

WVU Medicine Culture

WVU Medicine is committed to providing exceptional patient care and creating a supportive and collaborative work environment. Our values include:

• Patient-centeredness: Putting the needs of our patients first.
• Quality: Striving for excellence in everything we do.
• Integrity: Maintaining the highest ethical standards.
• Teamwork: Working together to achieve common goals.
• Innovation: Embracing new ideas and technologies to improve patient care.

How to Apply

To apply for the Clinical Quality Specialist position at WVU Medicine Peak Health, please click the "Apply" button at the top of this page and complete the online application. Be sure to include your resume and cover letter, highlighting your qualifications and experience.

FAQ

1. What are the minimum qualifications for this position?
   Current unencumbered licensure as a Registered Nurse in West Virginia or appropriate state OR Multi-state licensure through eNLC AND Four (4) years of healthcare clinical experience OR Bachelor’s degree in healthcare or business-related field AND Six (6) years healthcare quality management or performance improvement experience.
2. Is this a remote position?
   Yes, this position is remote.
3. What are the preferred qualifications for this position?
   Bachelor's Degree in Nursing; Managed Care knowledge or experience; Three (3) years Quality Management, Quality Improvement or Process Improvement Experience; Knowledge of CMS guidelines, regulations, NCQA® and HEDIS®; Thorough knowledge of Performance Improvement Projects (PIPs); Ability to work with large data sets and analyze information.
4. What are the core duties and responsibilities of this position?
   Plan, design, implement, and maintain a comprehensive program of continuous quality improvement (CQI) through HEDIS compliance rate tracking, trending and analysis as well as identifying existing challenges, inefficiencies and areas in need of improvement or intervention.
5. What is HEDIS?
   HEDIS (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures designed to allow purchasers and consumers to compare the performance of managed health care plans.
6. What is NCQA?
   NCQA (National Committee for Quality Assurance) is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations.
7. What are Performance Improvement Projects (PIPs)?
   Performance Improvement Projects (PIPs) are systematic activities designed to bring about positive changes in a specific aspect of healthcare performance.
8. What is the salary range for this position?
   The estimated salary range for this position is $65,000 to $95,000 per year.
9. What benefits does WVU Medicine offer?
   WVU Medicine offers a comprehensive benefits package, including health insurance, paid time off, retirement plan, and more.
10. What is the company culture like at WVU Medicine?
    WVU Medicine is committed to providing exceptional patient care and creating a supportive and collaborative work environment.