Location: Pittsburgh, PA
Cap-Exempt H-1B Position — No lottery required
UPMC Health Plan is hiring a full-time Coordinator, Quality Improvement. The team is based out of downtown Pittsburgh US Steel Tower, and this role will work in a hybrid structure with 3 days in the office per week - Monday, Wednesday, and Thursday. Preference will be given to local candidates; however, we are open to considering non-local individuals over 50 miles from the office on a remote basis. This position is a valuable contributor to the Health Plan’s Quality Improvement Program, supporting various functions. This team member is one that enjoys the challenge of working independently but also has the ability to collaborate effectively across a wide variety of stakeholders. This position is heavily focused on assisting the Health Plan to achieve NCQA Health Plan Accreditation, LTSS Distinction, Health Outcomes Accreditation, and/or Community Focused Care Accreditation through effective project management skills. This focus on Accreditation requires the incumbent to have a strong ability to collect, abstract, and analyze data for purposes of advancing quality improvement initiatives and achieving the Health Plan’s goals of excellence. Additionally, responsibilities may include, but are not limited to, delegation oversight, committee support, performance monitoring and assessment, and provider education and improvement activities. **Responsibilities:** - Assume accountability for assigned standards from the National Committee for Quality Assurance (NCQA), including oversight of delegated activities. - Collaborate with UPMC Health Plan departments, such as Marketing, Third Party Contracting, Legal, Network Management, Member Services, Claims Payment, Pharmacy Services, Utilization and Medical Management, Care Management, and Credentialing as well as delegates to ensure that NCQA standards are met and appropriate documentation is maintained. - Perform duties and responsibilities in accordance with the philosophy, standards and policies and procedures of the UPMC H