Performance Measurement Specialist: CalOptima

CalOptima is a public health plan, created by its community, governed by its community, and accountable to its community. CalOptima is authorized by state and federal law to administer Medi-Cal, Healthy Families, Healthy Kids, and Medicare benefits to Orange County ’s low-income, aged, and disabled residents. CalOptima serves over 320,000 members, is the largest of the County Organized Health System plans in California , and is the largest insurer of children in Orange County .

CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner.

PERFORMANCE MEASUREMENT SPECIALIST

The Performance Measurement Specialist will plan, direct and coordinate quality monitoring and improvement projects and data collection to complete performance measurement to ensure that Quality Improvement goals and objectives are accomplished within specified time frames, through the judicious and efficient use of CalOptima resources. This position has the lead responsibility for all HEDIS® and other performance measurement data collection and reporting activities. Must be able to communicate updates and project status to HEDIS® team and to other stakeholders for HEDIS/ QI projects and activities.

Candidates must be able to communicate effectively in writing and orally, including public presentations. Must possess the ability to understand and interpret written materials to determine regulatory and contractual requirements. Responsible for collecting data, identify pertinent information and preparing reports and presentations. Must be able to prepare quantitative analysis and data stratification of performance measures for presentation at committee meetings.

Bachelor's degree in Public Health, Health Policy, Health Care Administration or a related field is required. Experience in HEDIS and the HEDIS compliance audit process. Minimum of three (3) years experience in a managed health care setting; or equivalent combination of education and experience. Minimum one year supervisory and project coordination experience required. Knowledge of program specifications for HEDIS, NCQA, CMS, DHS, and other quality performance standards.

CalOptima offers an excellent work environment that includes flexible scheduling plans, a highly competitive benefits package and an organizational mission that drives our employees to excel!