Quality Improvement Specialist

Site: Mass General Brigham Health Plan Holding Company, Inc.

 

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

 

 

Job Summary

The Quality Project Management Specialist is responsible for coordinating and managing projects aimed at improving the quality of care, ensuring compliance with regulatory standards, and enhancing member satisfaction within the health plan. This role involves the development, implementation, and evaluation of quality improvement initiatives, working closely with cross-functional teams to achieve organizational goals. The Specialist will oversee and lead projects from initiation to completion, ensuring that they are completed on time, within scope, and on budget. The role requires a strong understanding of project management methodologies, processes, and tools; driving project teams, coordinating resources, and is the primary point of contact for stakeholders.

Essential Functions
Project Management
• Lead and manage multiple quality improvement projects across the health plan, ensuring they are completed on time, within scope, and meet the organization’s objectives.
• Develop project plans, timelines, budgets, and resource allocations, adjusting as necessary to ensure project success.
• Monitor project progress and identify risks, issues, or delays, implementing corrective actions as needed.
• Communicate regularly with internal and external stakeholders to ensure expectations are managed, issues are addressed, and the project is on track
• Work with cross-functional teams, ensuring that roles and responsibilities are clearly defined and progress is tracked.
• Proactively identify and mitigate project risks and issues, adjusting plans as necessary to ensure project success.
• Monitor and control project budgets, ensuring resources are used efficiently and effectively.
• Ensure that deliverables meet the required quality standards and stakeholder expectations.
• Provide regular status updates and detailed reports to leadership and stakeholders, documenting all project activities, milestones, and changes.

Quality Improvement
• Drafting, reviewing, and revising internal policies and procedures to ensure alignment with industry standards, legal requirements, and best practices.
• Support quality improvement (QI) projects using methodologies such as PDSA, Lean, or Six Sigma.
• Support the development and implementation of health plan quality improvement initiatives focused on improving clinical outcomes, operational efficiency, and customer satisfaction.
• Monitor and analyze health plan performance data to identify areas for improvement, developing actionable insights and solutions.
• Collaborate with clinical teams, operations, and IT to ensure quality metrics are met, and quality programs are integrated across the health plan.
• Ensure that quality projects align with state and federal regulations, such as CMS (Centers for Medicare & Medicaid Services) standards, NCQA (National Committee for Quality Assurance) requirements, and other applicable regulatory frameworks.
• Monitor and support audits and reporting requirements related to quality measures and performance metrics.
• Collect, analyze, and interpret data related to health plan quality, including clinical, operational, and member satisfaction data.
• Prepare and present reports on project progress, outcomes, and key performance indicators (KPIs) to senior leadership and stakeholders.

• Other duties as assigned

 

Qualifications

Education

• Bachelor's Degree Related Field of Study required (experience can be substituted in lieu of degree); Master's degree preferred

License

• Project Management Professional (PMP) certification preferred
• Certification in healthcare quality or equity (e.g. CPHQ, CPHE, Lean Six Sigma, etc.) preferred

Experience

• At least 2-3 years of experience in Quality Improvement, preferably in a healthcare setting required
• At least 5 years in health plan quality in a manager care organization highly preferred
• At least 3 years in project management highly preferred
• Experience in healthcare quality, health equity initiatives, population health, or related program coordination highly preferred
• Familiarity with QI methodologies and regulatory standards highly preferred<