The Quality Specialist core function includes assuring ongoing organization-wide regulatory and accreditation readiness. Core functions also include full responsibility for all quality related activities to include, but not limited to, accreditation and regulatory efforts associated with or required by the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS), a registered trademark of NCQA, the Department of Medical Assistance Services (DMAS), the Centers for Medicare and Medicaid Services (CMS) and other required entities associated with or required by the State and/or Federal Government. The Quality Specialist shall also be responsible for performing quality reviews, maintaining interdepartmental communication and education related to expected quality standards, and serving as the liaison for regulatory and accreditation quality standard requirements. Travel is mandatory.
MINIMUM EDUCATION REQUIREMENTS
SPECIAL KNOWLEDGE AND/OR SKILLS
Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs. Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia.
We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.
Our mission is to inspire healthy living within the communities we serve!