Market Quality Improvement Specialist II

CareSource

. Collaborate with department managers and leadership to evaluate opportunities for HEDIS data and process improvement .

Posted 9/23/2026full-timeRemote • United StatesMid-LevelSenior💰 $62,700 - $100,400 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in quality improvement methodologies such as PDSA, Lean, and Six Sigma, with a strong focus on data analysis and process improvement in healthcare settings. Proficient in leading teams, facilitating meetings, and communicating effectively across various levels of an organization.

Highest-signal resume keywords

Quality Improvement MethodologiesData AnalysisTeam FacilitationHealthcare ExperiencePDSA Cycle Documentation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisProcess ImprovementQuality Improvement MethodologiesPDSA Cycle DocumentationSurvey Tool DevelopmentMetrics TrackingMicrosoft Office SuiteLean MethodologySix SigmaGap Analysis

Soft Skills

Excellent Communication SkillsInterpersonal SkillsAttention to DetailCritical ThinkingProblem-Solving Skills

Certifications & Qualifications

Certified Professional in Healthcare Quality (CPHQ)American Society for Quality (ASQ)

Industry Keywords

HealthcareManaged CareMedicaidMedicareFederal RegulationsState RegulationsAccreditation StandardsQuality Improvement Plans (QIPs)Performance Improvement Plans (PIPs)Maternal Child Health

About the role

Key responsibilities & impact

Collaborate with department managers and leadership to evaluate opportunities for HEDIS data and process improvement
Conduct business process and gap analyses to diagnose improvement opportunities and develop reusable solutions
Lead improvement work teams, including team-member identification, meeting coordination and facilitation, and project management
Support documentation of QIPs, PIPs, and other quality activities
Train, educate, and deploy improvement tools, methods, and processes across assigned departments
Analyze work processes to identify improvement opportunities
Establish and implement measurement and data-collection methods with management and improvement teams
Review and measure progress and take appropriate action
Research best practices across industries
Develop, evaluate, and implement survey tools
Analyze survey data to inform improvement initiatives
Coordinate and participate in quality improvement committee meetings; develop agendas, prepare minutes and presentations, and follow up on action items
Communicate with upper management, peers, department staff, internal disciplines, outside agencies, and other entities to exchange information and resolve issues
Track, compile, and report program and project metrics
Research, gather, and analyze data to identify improvement opportunities
Work with Maternal Child and Health Outcomes Management and Vendor Management to monitor vendor and community partner performance
Monitor monthly, quarterly, and annual vendor reporting for timely receipt and accuracy
Participate in workgroups and applicable committees
Prepare reports, briefing materials, and other requested deliverables
Perform other job-related instructions as requested

Requirements

What you’ll need

Bachelor’s degree or equivalent years of relevant work experience is required
Minimum of three (3) years of healthcare or managed care experience is required
Experience using the Model for Improvement (PDSA – Plan, Do, Study, Act) is preferred
Medicaid and/or Medicare experience is preferred
Knowledge of quality improvement methodologies, including Model for Improvement, Lean, and Six Sigma
Proficient in leading teams through establishing aim statements and identifying small tests of change
Proficient in establishing and documenting PDSA cycles and key driver diagrams
Excellent team facilitation skills
Research, data analysis, and trending skills
Proficient in Microsoft Office Suite, including Word, Excel, and PowerPoint
Excellent written and verbal communication skills
Ability to develop, prioritize, and accomplish goals
Ability to work independently and within a team environment
Attention to detail
Familiarity with the healthcare field
Familiarity with applicable Federal regulations, State regulations, and accreditation standards
Effective listening, critical thinking, and problem-solving skills
Strong interpersonal skills and high level of professionalism
Training/teaching skills
Certified Professional in Healthcare Quality (CPHQ) or American Society for Quality (ASQ) certification preferred
Ability to sit or stand for extended periods in a general office environment

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Comprehensive total rewards package
Equal Opportunity Employer environment focused on belonging and support
Some in-state travel required, up to 10% of time