What you will do:
- Manage and oversee risk and quality management programs to ensure compliance with industry standards and regulations.
- Collaborate with cross-functional teams to develop and implement strategies for mitigating risks and improving quality of care.
- Conduct regular audits and assessments to identify areas of improvement and recommend corrective actions.
- Analyze business data and performance metrics to identify care gaps and opportunities for optimization.
- Develop and maintain reports and dashboards to track key performance indicators and communicate insights to stakeholders.
- Work closely with stakeholders to prioritize initiatives and drive continuous improvement in risk and quality management processes.
- Provide support and guidance to operational teams to ensure adherence to best practices and standards.
- Stay updated on industry trends and best practices in risk and quality management to inform decision-making and drive innovation.
What you will bring:
- Bachelor's degree in business administration, healthcare management, or related field; advanced degree preferred.
- Proven experience in risk and quality management within the healthcare industry.
- Strong analytical skills with the ability to interpret complex data and generate actionable insights.
- Excellent communication and interpersonal skills with the ability to collaborate effectively with cross-functional teams.
- Experience with business intelligence tools and data visualization techniques.
- Ability to prioritize and manage multiple projects simultaneously in a fast-paced environment.
- Strong attention to detail and a commitment to delivering high-quality results.
- Knowledge of healthcare regulations and compliance requirements.
- Certification in risk management or quality improvement (e.g., Certified Professional in Healthcare Risk Management - CPHRM) is a plus.
About Edifecs
Edifecs is a premier technology company in the U.S. Healthcare market with solutions focused on interoperability, workflows, risk adjustment, value-based care payments, and analytics. Edifecs solutions are used by leading healthcare entities including, payers, providers, employers, third-party administrators, and government agencies. With innovative technology and solutions, Edifecs helps its customers by optimizing the secure exchange and processing of administrative and clinical data, reducing the cost of complying with regulations, and automating workflows involved in multiple core processes within the healthcare ecosystem. Edifecs is a frontrunner in providing solutions for B2B data exchange, streamlining key workflows in areas such as enrollment, risk adjustment, and alternative payment models. With the advent of FHIR and new regulatory guidance from HHS, Edifecs has emerged as a leader in easing the effort associated with achieving compliance with new federal rules and in making the healthcare consumer the primary stakeholder. Edifecs solutions are offered in both On-Premise and SaaS models. The company is headquartered in Bellevue, Washington, with additional offices in Atlanta, Georgia, and Mohali, India, an engineering center in Moldova, and has more than 700 employees.