Quality Improvement Specialist

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

 

Summary

As a Quality Improvement Specialist at Gainwell, you’ll be part of a highly collaborative team that is responsible for continuous quality improvement to Gainwell Pharmacy Benefit Manager services in Ohio. We define, implement, and evaluate data-driven strategies to achieve high quality outcomes for populations served by the Ohio Department of Medicaid (ODM) Single Pharmacy Benefits Manager (SPBM). We’re seeking a creative problem solver and team player who uses strong communication and problem-solving skills to contribute to our day-to-day quality improvement activities.​ 

You will be able to apply an intermediate level of subject matter knowledge to solve a variety of healthcare access and quality improvement from a pharmacy perspective. You'll work on problems of moderately complex scope. Acting as an informed team member providing analysis of information and facilitates project groups. Exercising independent judgment within defined practices and procedures to determine appropriate action. Following established guidelines and interprets policies. Evaluating unique circumstances and making recommendations.

You'll facilitate quality improvement projects with oversight of the Ohio Department of Medicaid (ODM), to improve quality measures related to the PSBM pharmacy benefit. This will include being a resource for project vetting, organizing project timelines, scheduling and documentation, leading meetings and ensuring all steps through the PDSA Milestones are accomplished.

Here are the details on this position.

Your role in our mission

• Facilitate Quality Improvement Projects following PDSA methodology from start to finish
• Be a resource for all departments to analyze potential quality improvement projects, assist with development and
  implementation.
• Assists in analyzing and documenting quality improvement opportunities, including planning data needs,
  team building and root cause analysis.
• Assist in the PDSA cycle to ensure IHI Model for Improvement methodology is followed through the Milestones from
  planning to sustaining
• Assists in maintaining documentation and files, building presentations and keeping projects organized
• Professionally engage and participate in meetings with clients and Managed Care Entities in collaboration projects,
  report-outs and as a subject matter expert.
• Participates in meetings as an active voice representing quality improvement projects, successes and
  lessons learned
• Leads project meetings, planning meetings and follow-up meetings to ensure clear communication and
  expectations are met

• Participates in group activities to build and organize project plans, timelines and team meetings

What we're looking for

• 3-5 years Quality Improvement experience working with the interface of information technology with functional groups within an organization
• Bachelor's degree in business or healthcare management discipline is preferred
• Requirements determination using structured techniques for documentation, analysis, evaluation / validation
• Decomposition of high-level information into details
• The Ability to Distinguish between:
  Requests vs Needs and Requirements vs Solutions
• Classifying and prioritizing requirements
• Applying creativity to solving complex problems
• Building relationships and working collaboratively
• Effective Verbal and Written Communication

Essential qualities

• MS Office - Word, Excel, PowerPoint, SharePoint, Teams
• SME in Quality Improvement, Methodologies
• Strong Analytical and Problem-Solving S