Let’s do great things, together

Founded in Oregon in 1955, ODS, now Moda, is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.

Moda is seeking a Health Promotion & QI Specialist III. This role Develops, implements, and evaluates member and provider education projects designed to promote health and improve the quality of healthcare services delivered to all lines of business and product lines.

This is a Hybrid PST position. We are only offering this position to candidates in OR or WA.

Benefits:

• Medical, Dental, Vision & Pharmacy
• 401K and FSA
• PTO and Company Paid Holidays

Requirements:

• Bachelor’s degree required; Master’s degree (in Public Health) preferred.
• Familiar with HEDIS, CAHPS, NCQA.
• Experience with quality metric standards preferred for HEDIS, Marketplace and Medicare Stars.
• Experience in project plan coordination, management, and development.
• Strong analytical, problem solving, decision making, organizational, and detail orientation skills.
• Experience working with healthcare staff and leadership to convert monitoring and evaluation data into action plans.
• Proven project management skills: ability to track and coordinate multiple projects with extended timelines.
• Strong verbal, written and interpersonal communication skills.
• Strong literature search and literature review skills.
• Demonstrated ability to translate complex findings into clear, user-friendly, and action-oriented messages.
• Experience in a health-related field specializing in electronic medical records systems preferred.
• Self-starter with ability to propose and implement creative solutions.
• Ability to maintain confidentiality and project a professional business image.
• Proficiency in Microsoft Office, especially MS Excel and other reporting software.

• Document and report quality initiatives to appropriate internal and external stakeholders.
• Coordinate with marketing staff and vendors as needed to update, create, or purchase relevant member and provider communications.
• Work with other Moda departments to develop and vet program materials using guidelines established by marketing, compliance, HEDIS, and NCQA.
• Coordinate with Moda departments to ensure compliance with company standards.
• Ensure compliance with applicable state and national quality assurance and quality improvement standards.
• Facilitate project development and quality improvement initiative meetings and participate in medical quality committees and workgroups.
• Develop annual project work plans resource allocations and budget impacts.
• Develop, implement, and evaluate multiple independent project-deliverables required to support the Quality Improvement team.
• Oversee data collection related to health promotion and quality improvement activities.
• Monitor and report the outcomes of health promotion and quality improvement activities and program success indicators to supervisor and quality committees.
• Oversee the collection and analysis of data and prepare pertinent documentation and reporting for quality improvement committees, regulatory agencies and other oversight entities.
• Prepare for audits and reviews by external organizations, including the National Committee for Quality Assurance (NCQA), the Centers for Medicaid and Medicare Services (CMS), and the Oregon Health Authority (OHA).
• Work as the primary point person/liaison with the clinic staff at provider practices for quality initiatives.
• Develop and update quality improvement policies and procedures.
• Participate in community collaborations and meet with external stakeholders
• Seek out and participate in professional growth and development activities.
• Proven, independent project development and quality improvement skills. Subject matter expert in assigned products and programs including quality metrics.
• Plan and assign quality activities and tasks with a variety of outside entities and a diverse work force, including leadership, operational staff, regulatory, business analysts, technical teams, marketing and finance.
• Through healthcare research, evaluations and quantitative analysis, summarize and synthesize complex data & information to identify trends & patterns, pinpoint issues and areas for improvement, and recommend solutions and next steps.
• Perform other duties as assigned.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.

For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our humanresources@modahealth.com email.