quality specialist
alamal hospital
Total years of experience :18 years, 10 Months
• strong Technical documentation skills,
• Quality Assurance skills,
• technology skills.
• Understanding of Programming fundamentals.
• BASIC Project Management skills and strong organizational skills.
• Client focused.
• Willingness to work in a team environment and independently.
• Strong documentation skills.
• Knowledge of medical terminology, anatomy, and physiology.
• Experience with customer support
• Database management (Access or SQL) .
collect, analyze and report on a variety of data to assess the quality and appropriateness of care and treatment of members and to provide oversight in the allocation and utilization of program resources.
Develops and implements metrics and performance targets that assess compliance with CMS regulations and best practices in medical management.
Oversee/perform audits of medical management staff for compliance with health plan policies and procedures and with regulatory and accreditation requirements. Assure that quality assurance audits and oversight activities are completed in a timely fashion and reported to audited entity within required time parameters. This function may require travel within and outside the Houston area.
Utilizes quality assurance and quality improvement evaluation methodologies for measurement of protocol compliance and to sustain survey readiness, including ongoing internal competency/preparedness review.
Analyzes data to determine trends and resource utilization for use in optimizing compliance and to prepare reports describing individual performance.
responsibile for coordination of the work order process and medical documentation development within KFMC.
supports the development and implementation of quality improvement measures and audits, and assists in improving quality processes throughout the enterprise through coordinating and engaging in activities to resolve deficiencies.
monitors, performs, or manages quality improvement processes including those supporting compliance to regulatory and/or accreditation standards.
lead and develop the Quality Assurance function including Health, Safety & Environmental, to offer timely and effective support to production and to ensure good effective communication with all customers and suppliers on all quality related issues.
