Senior Clinical Quality Improvement (Outreach) Specialist
Location: Milwaukee, Wisconsin, United States
Remote Opportunity: 0
Requisition Number: 2077
Position Title: National Outreach Specialist, Senior
Develop member outreach and wellness initiatives that maximize goals related to: 1) increases in clients’ member access and utilization of services, 2) clients’ overall cost of care, and 3) Enterprise oral health leadership
JOB DUTIES AND RESPONSIBILITIES:
- Manage outreach programs nationally by understanding performance metrics including but not limited to, QARR , HEDIS, CMS-416, cost implications of care, and state incentives per client.
- Develop outreach plan and ensure successful execution as evidenced by improvements in performance metrics.
- Lead development of budget to finance interventions designed to improve access to care, performance metrics and quality outcomes.
- For all markets, understand financial impact of increases in access as it correlates to cost of care.
- Be able to demonstrate cost/benefit analysis and options for specific markets, and for general capabilities as related to sales and business development.
- Provide strategies and recommendations to increase access to care within stringent budgets.
- Develop strategies that manifest DentaQuest’s oral health mission for members that is tangible both at the national level, as well as within specific states/markets.
- Serve as the liaison between the Foundation, Institute and business units.
- Collaborate with regional outreach coordinators and Member Communications Specialist to ensure outreach best practices are shared across all markets and outreach activities are integrated nationally.
- Provide Project Management to cross functional teams to assure successful implementations of new business.
- Create and improve implementation workflows between departments to ensure client deliverables are being met, according to the contract.
- Completion of HEDIS roadmap appendix for dental and vision Represent DentaQuest in a professional manner at all times. Completes special projects as requested.
- Adhere to DentaQuest business processes.
- Perform clinical peer reviews.
- Other duties as assigned.
- College degree or relevant experience required.
- 2 years job related experience Knowledge of clinical and industry terminology and procedures.
- Project management, organizational skills, and prioritization skills required.
- Self-motivated, and ability to work with little supervision.
- Strong analytical skills.
- Strong problem solving skills and the ability to make independent decisions.
- Strong written and oral communication skills.
- Ability to travel Required to attend additional training as requested/deemed necessary
- Experience working in a managed care environment a plus
- Knowledge of quality improvement methodologies and population health management is desirable.
- Knowledge of general computer software (Excel, MS Word, and Access is preferred).
Incumbent must be able to communicate effectively. Requires overall light physical effort (up to 25lbs.) Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal computer). Ability to travel or move about within and outside serviced facilities required. Incumbent works primarily in either a private or shared office environment.
Community / Marketing Title: Senior Clinical Quality Improvement (Outreach) Specialist
At DentaQuest, we believe that everyone should live life free of dental disease. As a purpose-driven, double bottom line company that is improving oral health for everyone, we are transforming the oral health system – from the way we provide care and pay for it, to how we talk about it and prioritize it in our policies and communities.
Meaningful change requires a revolution in oral health. We are redefining what it means to prevent disease and provide better access to care for everyone. We are going beyond the dental chair to reshape the oral health system, addressing total health and the social and cultural factors that impact it.
To make this revolution a reality, we harness our unique reach and insights to advance policy, financing, care, and the community. That means solving problems in a flexible and efficient way, testing and trialing to create new solutions and delivering measurable outcomes for the people we serve.
The people of DentaQuest have a common purpose, and we work together with passion, perseverance and focus to achieve a nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth for their entire lives. Where every person has access to quality dental care.
Location_formattedLocationLong: Milwaukee, Wisconsin US
CountryEEOText_Description: Equal Employment Opportunity Statement: DentaQuest is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, sex, age, disability, marital status, or sexual orientation.