Quality Improvement Specialist Resume Samples

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Quality Improvement Specialists are found in the medical industry and work to improve medical care through various methods. Typical work activities seen on a Quality Improvement Specialist example resume are collecting relevant data, observing how care is delivered, identifying and addressing issues, interviewing employees, and recommending solutions for improved care. A well-written resume for the role should focus on skills like knowledge of healthcare issues and medical terminology, analytical thinking, problem solving, organizational skills, attention to details, and leadership. Training in a field like nursing, health care administration or public health is required.

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1

Quality Improvement Specialist & Coach

Trained sales agents in improved selling strategies as well as current compliance standards. Partnered with Sales Supervisors to develop individualized action plans for employees to boost performance and productivity. Spearheaded compliance workshops to ensure all agents were supported in meeting expectations and received constructive feedback.

  • Received highest performance rating ("Excelling") on final review prior to company shut down.
  • Piloted Quality Coach role stemming from extensive management experience. Drove 10%+ increase in sales and compliance performance by veteran agents through targeted training and feedback.
  • Created up-to-date compliance reference materials and led training for five classes of agents.
  • Provided one-on-one training for new Sales Supervisors to expedite onboarding and enhance knowledge and leadership skills.
  • Monitored live and recorded customer calls to provide immediate opportunity feedback.
  • Resolved complaints from state insurance departments and national accounts through collaboration with key team members and departments.
  • Served as compliance subject matter expert (SME) to management and coached new Quality Improvement Specialists on policies and procedures.
Candidate Info
13
years in
workforce
3
years
at this job
BS
Bachelor of Science
2

Quality Improvement Specialist

Major focus on leading and executing a mixed portfolio of strategic initiatives, projects and programs to deliver improvements to quality, reliability, safety and satisfaction of resident/employee experience.

  • Defines, develops and builds out infrastructure and standards to execute projects including methodologies, tools and templates
  • Teach and coach performance improvement and project management effectively, working with frontline and middle management staff to improve their knowledge, capacity and process improvement tools to solve problems
  • Act as a change agent, and builds and manages relationships across the organization
  • Helps implement and sustain visual management systems and reviews at all levels across the organization
  • Preform process improvement project organization, analysis and implementation, and utilizes scheduling, project task lists, milestone tracking/reporting, etc.
Candidate Info
28
years in
workforce
2
years
at this job
BS
Business
3

Sr Quality Improvement Specialist, Compliance

  • Provided technical expertise and coordination for improving health plan core measures and key performance indicators related to Medicare-Medicaid line of business to senior leadership team, including identifying gaps in performance as well as regulatory and legislative interpretation.
  • Effectively collaborated with Compliance Program Oversight Unit staff by performing qualitative and quantitative analysis to identify gaps in plan performance, development of improvement plans and measurement to assess impact of actions.
  • Managed and facilitated the implementation of DHCS performance improvement activities that lead to a positive and measurable impact on process and outcomes measures.
  • Provided support to the QI Director to track, monitor, report, and trend performance related to planning, development and operations of the Compliance program.
  • Participated in NCQA accreditation and regulatory audit preparedness and maintained activities, including preparing reports, narratives, graphs as needed for external audits and surveys related to specific topic areas.
Candidate Info
9
years in
workforce
2
years
at this job
MA
Public Health
4

Quality Improvement Specialist

  • This role functioned as an hospital Quality (Performance Improvement, Infection Prevention) subject matter expert for coordinated, statewide initiative to reduce hospital acquired infections (HAI), Readmissions, Sepsis coordination, Length of Stay and more with the goal of reducing overall patient harm and enhancing patient & family experience in healthcare.
  • In charge of 21 facilities' compliance and served as a Liaison for best practices.
  • Arrange and facilitate monthly collaborative calls as required by project deliverables
Candidate Info
4
years in
workforce
9
months
at this job
Medical
5

Quality Improvement Specialist

  • Member of a team of specialists assigned to statewide coverage of Georgia, for a major Medicare/ Medicaid managed care organization. Activities include on-site, electronic transmission and other means of completing audits.
  • Monitor Quality Improvement initiatives to ensure compliance with HEDIS measure set standards.
  • Perform medical record reviews utilizing clinical specialization specific criteria; facilitate educational support to providers regarding appropriate clinical documentation commensurate with high quality patient care.
  • Collect and summarize performance data, identify and counsel provider about opportunities for improvement.
Candidate Info
26
years in
workforce
1
year
at this job
AS
Applied Science
BS
Biology
BS
Nursing
6

Quality Improvement Specialist

  • Perform data analysis and reporting for health plan’s quality improvement initiatives.
  • Utilize a variety of reporting tools to analyze, verify and compile member data.
  • Analyze quality performance score cards and report opportunities for improvement to management.
  • Create weekly, monthly and ad-hoc reports for Medicare and Marketplace product lines.
  • Assist with verification and cleansing efforts to maintain data integrity and quality.
Candidate Info
17
years in
workforce
2
years
at this job
Information Systems
7

Geisinger Quality Improvement Specialist (gqi) (coach/consultant)

  • Facilitates, trains, and leads the development and implementation of improvement programs within assigned areas/department microsystems to achieve efficient healthcare across the continuum of care
  • Demonstrates a comprehensive understanding of the theory and principles of clinical performance/ transformational improvement while adhering to stringent quality measures and regulations
  • Conducts didactic training sessions for providers, administration, professional and front line staff
  • Active member of inpatient and outpatient regulatory mock tracers
Candidate Info
18
years in
workforce
2
years
at this job
8

Quality Improvement Specialist

  • Track and Trend all incentive attestations within the Member Incentive Program
  • Created an internal survey for MLTC, FIDA, & Medicare. Up to and including methodology, tracking, and coordinating with the vendors, criteria, exclusions, timelines
  • Draft and assist in creating the member newsletter; also created topic outline by seasons, and adjusted the reading grade level for all MLTC & FIDA population
  • Created educational content for organizations social media page to be posted by corporate communications
  • Request, reviewed, and compared various vendor proposals for services
  • Conduct monthly internal IQC audits on Care Managers with new enrollee's (including the welcome call within week one, home visits within first 30 day, and member call to PCP ratio within first 30 days)
  • Responsible or sending out LHCSA (Licensed Home Care Service Agencies) score cards quarterly to all participating LHCSA's
  • New hire orientation training for Human Resources to update and educate new hires on the Quality Management Department
  • Conduct Root Cause analysis of Missing 6 month UAS reassessments, for Utilization Management to determine gaps and delay(s).
  • Assist with all HEDIS initiatives, including the HEDIS Roadmap, onsite audit, working with contracted vendors, and assisting with the IDSS filing.
Candidate Info
6
years in
workforce
2
years
at this job
BA
Business Aministration
BA
Business
9

Quality Improvement Specialist

  • Schedule and manage all interior and exterior accounts
  • Perform quality checks on interior and exterior accounts
  • Perform reviews with clients to guarantee satisfaction
  • Assist in the install and design of plants for new accounts
  • Input and manage the inventory
Candidate Info
6
years in
workforce
2
years
at this job
AAS
Business Management
BS
Business Management
10

Quality Improvement Specialist

  • Provides administrative support for routine correspondence related to quality initiatives, including fax, scanning, email, and hard-copy of correspondence.
  • Conducts telephonic outreach to members to support ongoing quality initiatives.
  • Provides coordination and support for medical records retrieval.
Candidate Info
7
years in
workforce
1
year
at this job
BA
Business Administration

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