quality improvement ( QI) methods
- Bachelor’s degree or sufficient work experience to equal the degree
- 3+ years of related analytical/financial experience
- 3+ years of managed care/health care experience required
- Strong interpersonal skills, with the ability to interact effectively with all levels of staff
- Solid understanding of managed care, Medicaid, Medicare, health insurance industry
- Ability to build and maintain relationships internally and externally
- Demonstrated ability to identify issues and propose solutions; experience using and commitment to continuous
- Strong communication skills, both written and verbal
- Ability to work independently, with minimal supervision and as part of a team
- Computer skills required ( Microsoft Office)
- Strong organizational and prioritization skills
Duties and Responsibilities - Responsibilities include, but are not limited to the following:
- Knowledge of Health Insurance Exchange
- Experience with Microsoft Project and SharePoint
o Responsible for the implementation of new products working closely with Business leads, Product Manager, and
- Product and Program Implementation
Project Management Office.
- Manage new product planning and implementation activities.
- Understand and communicate state and federal requirements; ensure programs and business processes meet
o Work with business owners to develop necessary response for new products within scope of financial analysis,
gap assessment and market knowledge.
o Point person for external contacts/meetings.
- Develop and manage to work plans.
- Collaborate on state and/or federal readiness reviews.
- Ensure capabilities are in place to meet reporting requirements.
o Identify and research program development opportunities.
- Collaborate with business owners to provide insight and recommendations to senior leaders on new program
o Conducts and interprets quantitative/qualitative analysis and highlights implications of findings.
- Work closely with business leads to implement new program opportunities.
o Represent Neighborhood at external meetings.
o Support health care research activities including: gathering, interpreting and analyzing data and trends on
- Research and Benchmarking
health care industry, managed care, Medicaid, Medicare, health care policy and related topics resulting in the
identification of changes to state health care and Medicaid policy and identification of clinical practice and
operational improvements for the company.
o Develop summaries of research findings including implications and recommendations for dissemination in
support of strategic and business planning as well as policy development.
o Work closely with Marketing and External Affairs Department along with appropriate subject matter experts to
define company policy position; collect relevant data; develop policy position documents.
o Collaborate with business owners to identify, strategize and implement policy development opportunities;
Products include White Papers and research briefs
o Collaborate with Community Health Center and RI Health Center Association executive leadership to identify
CHC opportunities and needs around innovative services.
- Participates in or oversee cross-functional teams.
- Collaborate with team members to document key work flows, policies and procedures of Business Development
- Develop or participate in QI projects directly related to Business Development Department or other business
Neighborhood is an EOE M/F/D/V and an E-Verify Employer.
- Other duties as assigned.
Neighborhood Health Plan of Rhode Island - 2 years ago
The overall health of the people of Rhode Island is overseen by the Rhode Island Department of Health, which is overseen by a...