Remote Jobs in Wilmington, NC

LOCATION : Remote - this is a virtual, home-based position that operates within the hours of 8 : 30am-5 : 00pm on US Eastern Standard Time (EST). Vaya Health welcomes applications from NC, SC, GA, TN, VA, MD, and FL.

GENERAL STATEMENT OF JOB

This position is responsible for the management of the Quality Assurance Performance Improvement (QAPI) activities within Vaya to ensure high levels of performance within established quality improvement processes of the organization. This position is part of the Quality Management Department, reports to the Quality Director of NC Medicaid Managed Care Program and State-Funded Services, and will ensure that appropriate oversight, coordination, and communication occur with Quality Management and departmental leadership regarding any quality assurance concerns and potential improvement activities, including potential Performance Improvement Projects (PIPs). The Performance Improvement Specialist must have a strong background in performance management, process improvement, and organizational development. This role requires a strategic thinker who can identify areas of improvement and partner with leaders and subject matter experts (SME) across the organization to implement innovative and effective solutions. Strong leadership and meeting facilitation skills are required to lead diverse cross functional improvement projects. This role requires excellent communication skills, a passion for performance improvement and the ability to work within required timelines.

ESSENTIAL JOB FUNCTIONS

• Manage and coordinate the development and implementation of internal and North Carolina Department of Health and Human Services (NCDHHS)-required QAPI activities and initiatives.
• Develop, implement, and evaluate QAPI processes and procedures to monitor and ensure the quality and timeliness of quality activities, survey administration, and root cause analyses (RCAs).
• Identify effective solutions for improving performance utilizing appropriate quality management tools and methodologies.
• Conduct regular review and analysis of quality and performance measures, member surveys and assessments, incidents of harm, and other data sources to identify quality and performance deficits.
• Design and implement Performance Improvement Projects (PIPs) and other quality processes to identify and address quality and performance issues.
• Prepare required annual, quarterly, and ad hoc reporting associated with PIPs and other QAPI processes.
• Collaborate with various departments to ensure alignment with performance goals.
• Conduct training sessions to educate staff on performance improvement strategies.
• Monitor the effectiveness of implemented solutions and collaborate with subject matter experts to make necessary adjustments.
• Identify and mitigate risks associated with performance improvement initiatives.
• Guide improvement teams and relevant stakeholders through the established improvement process from problem conception to project completion.
• Work with the Performance Reporting Team, improvement teams, and the MIS Department to collect, validate, and deliver data relevant to improvement projects as needed.
• Coordinate with external vendors as needed.
• Facilitate groups and meetings to discuss performance issues and solutions.
• Partner with the Quality Director to support the administration of surveys to measure outcomes in the areas of quality of life, functional status and member satisfaction as requested by the Department and facilitate Vaya's participation in the annual Consumer Assessment of Healthcare Providers and Systems Plan Survey (CAHPS), CAHPS-ECHO, and Provider Survey conducted by the EQRO, and other surveys as required by the Department.
• Stay updated with the latest trends and best practices in performance management.

KNOWLEDGE, SKILL & ABILITIES

EDUCATION & EXPERIENCE REQUIREMENTS

Bachelor's degree required and at least two (2) years of quality assurance and improvement experience. Experience in a behavioral or medical managed care environment, especially quality assurance and improvement experience in this environment, is preferred

Preferred Licensure / Certification :

PHYSICAL REQUIREMENTS

RESIDENCY REQUIREMENT : The person in this position must live in NC, SC, GA, TN, VA, MD, or FL for this role.

SALARY : Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.

DEADLINE FOR APPLICATION : Open Until Filled

APPLY : Vaya Health accepts online applications in our Career Center, please visit

Vaya Health is an equal opportunity employer.