Health Educator / Quality Improvement

ob Title: Health Educator / Quality Improvement

Location: Remote (Must reside in KY)

Reports to: Quality Improvement Director

Job Summary

The Health Educator / Quality Improvement professional at a Managed Care Organization (MCO) plays a pivotal role in overseeing, developing, and implementing healthcare quality improvement initiatives and educational programs. This position ensures that healthcare quality standards are maintained and that key performance metrics are achieved through data collection, reporting, and monitoring. The Health Educator will focus on member interventions, particularly for closing HEDIS care gaps, with an emphasis on childhood immunizations. Additionally, they will support healthcare providers and internal teams with health education and quality improvement efforts.

Essential Functions

• Health Education Program Development: Design, implement, and evaluate health education programs tailored to the specific needs of members and the community.
• Quality Improvement Initiatives: Collaborate on key quality strategies, with a focus on initiating and managing interventions aimed at closing care gaps (e.g., HEDIS).
• Member Outreach: Make telephonic outreach to members and their parents, primarily focusing on ensuring childhood immunizations are up-to-date.
• Provider Support: Assist providers in meeting contractual health education requirements and improving overall quality of care.
• Liaison Role: Serve as a point of contact between internal teams, community-based organizations, social services, and public health departments to ensure relevant health resources are available.
• Data Management: Conduct data collection, reporting, and analysis for performance measurement activities. Contribute input to the design and functionality of databases used for quality improvement tracking.
• Administrative Leadership: In the absence of the manager or director, make administrative decisions and provide guidance to health educators in resolving implementation issues.
  
  

Required Skills And Experience

• Required Experience: Minimum 1 year of healthcare or clinical experience, ideally in a managed care or public health setting.
• Preferred Education/Experience: Medical Assistant, Nurse, or Public Health background preferred. HEDIS experience is strongly desired.
• Telephonic Customer Service Skills: Proven experience in customer service, especially in telephonic interactions with members and parents.
• Technical Skills: Proficiency in Microsoft Office (Excel, Word) and adaptability to fast-paced, changing environments.
• Work Experience: Experience with remote work, self-motivation, and time management.
  
  

Preferred Qualifications

• Molina Experience: Prior experience with Molina Healthcare or similar organizations is beneficial. Access to the CCA system is a plus.
• Clinical Background: Experience in a clinical role, including knowledge of health education, case management, or care coordination.
  
  

Benefits

• Competitive salary and comprehensive benefits package.