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Performance Improvement Evaluator II

Role overview

Qualifications

  • Master of public health or related field degree
  • Minimum of two years of relevant work experience in program evaluation
  • Experience using the model for improvement (PDSA-Plan, Do, Study, Act)
  • Previous healthcare or managed care experience preferred

Responsibilities

  • Assist with implementing and evaluating performance improvement and population health processes
  • Support the market Quality Director in conducting assessments using qualitative and quantitative methodologies
  • Contribute to the development, implementation and monitoring of action plans based on performance metrics
  • Monitor and provide reports regarding provider profiling, focus groups, and stakeholder interviews

Key facts

  • Remote from: United States
  • Full time
  • Mid-level (2-5 years)
  • $63K – $100K / year
  • English

Hard skills

Other skills

  • Microsoft Excel
  • Analytical Skills
  • Communication
  • Problem Solving
  • Critical Thinking

About the company

CareSource logo

CareSource

  • Health Insurance & Payers
  • Large
  • 1,001–5,000
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits. CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve. CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf Si usted o alguien a quien ayuda tienen preguntas sobre CareSource, tiene derecho a recibir esta información y ayuda en su propio idioma sin costo. Para hablar con un intérprete, Por favor, llame al número de Servicios para Afiliados que figura en su tarjeta de identificación. 如果您或者您在帮助的人对 CareSource 存有疑问,您有权 免费获得以您的语言提供的帮助和信息。 如果您需要与一 位翻译交谈,请拨打您的会员 ID 卡上的会员服务电话号码。

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Job description

Job Summary:

The Performance Improvement Evaluator II assists with implementing and evaluating performance improvement and population health processes through the integration of quality improvement science.

Essential Functions:

  • Serves as the market support in program evaluation, study designs, and methodological techniques
  • Support the market Quality Director to conduct assessments using qualitative and quantitative methodologies and continuous improvement tools to identify issues and opportunities to improve health outcomes 
  • Contribute to the development, implementation and monitoring of action plans based on performance metrics (State Agencies, AHRQ, HEDIS, CAHPS)
  • Support the market Quality Director and market business owners in developing and monitoring Performance Improvement Projects (PIPs)
  • Assist with developing quarterly and annual quality data analysis reports
  • Use basic statistical techniques, graphics and data to summarize HEDIS analytical needs to measure impact of various actions/results
  • Monitor and provide reports regarding, process of provider profiling, focus groups and stakeholder interviews
  • Identify opportunities for improvement in performance measure and survey scores based on evidence-based, results of quantitative and qualitative analysis
  • Assist in the development of focus studies using epidemiological methodology to target population for interventions
  • Conduct assessments to identify issues and opportunities using qualitative and quantitative methodologies and continuous improvement tools to improve health outcomes
  • Contribute to the development of surveys, evaluation designs and facilitation guides
  • Conduct process and gap analysis to diagnose process improvement opportunities and to develop re-usable solutions using principles of process excellence and related tools
  • Explore best practices across various industries to bring to the work team
  • Perform any other job related instructions, as requested

Education and Experience:

  • Master of public health or related field degree (e.g. health promotion, evaluation etc.) is required 
  • Minimum of two (2) years of relevant work experience in program evaluation is required
  • Experience using the model for improvement (PDSA-Plan, Do, Study, Act) is required
  • Previous healthcare or managed care experience is preferred

Competencies, Knowledge and Skills:

  • Proficient in Microsoft Word, Access and advanced proficiency in Excel is required
  • Knowledge of a variety of quality improvement methodologies – Model for Improvement, Lean, Six Sigma
  • Knowledge of establishing and documenting PDSA cycles and key driver diagrams
  • Analytic skills for solving problems
  • Knowledge of managed care and health care data coding is preferred
  • Graphic development/presentation skills
  • Familiar with descriptive statistical application and techniques
  • Critical listening, thinking skills, and verbal and written communication skills
  • Problem solving skills
  • Excellent writing skills

Licensure and Certification:

  • None

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$62,700.00 - $100,400.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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