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CareSourceCA

Performance Improvement Evaluator II

CareSource is a nonprofit managed care organization based in Dayton, Ohio, that serves over 2 million members with a wide array of Medicaid and Medicare products.

CareSource

Employee count: 1001-5000

Salary: 62k-98k USD

United States only

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:

$61,500.00 - $98,400.00

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

  • Create an Inclusive Environment

  • 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 inclusive environment that welcomes and supports individuals of all backgrounds.

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Mid-level

Salary

Salary: 62k-98k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About CareSource

Learn more about CareSource and their company culture.

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CareSource is a nonprofit, nationally recognized managed care organization established in 1989 that has grown to serve over 2.1 million members across various states in the U.S. With its headquarters in Dayton, Ohio, CareSource administers one of the largest Medicaid managed care plans in the country. The organization offers a wide range of health insurance products, including Medicaid, Medicare Advantage, and Health Insurance Marketplace plans. CareSource stands apart by addressing the social determinants of health which significantly impact the well-being and health outcomes of its members. This mission-driven approach enables them to provide personalized care solutions that cater to the unique needs of low-income and vulnerable populations.

As part of its commitment to innovative care delivery, CareSource continually enhances its services through technology and partnerships designed to streamline access to care and improve member experiences. The organization employs nearly 5,000 individuals who are dedicated to fostering community relationships and ensuring that every member receives high-quality care when needed. Their strategic initiatives focus on improving health outcomes, operational excellence, and social equity within the healthcare realm. In addition to traditional medical services, CareSource actively engages in health education and outreach efforts that foster resilience and self-sufficiency in the communities they serve. This approach contributes to a broader aim of not just treating illness but promoting overall health and wellness in society.

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CareSource

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