Healthcare Quality Business Development Specialist

Job Summary:

The Healthcare Quality Business Development Specialist supports the Quality function of new business implementations through reviewing and understanding current and prospective contracts and informing content for proposals, including identifying, collecting and managing documentation required for responses to Requests for Proposals (RFPs) and other business-related proposals.  This role will serve as a Quality liaison between Enterprise Implementation Organization, Enterprise Project Management Organization and the Quality & Performance Organization. 

Essential Functions:

• Review pre-work and in-flight RFP opportunities and advise proposal writers in the content development in response to RFP requirements
• Review and analyze cross-functional data needed to support RFP and other proposal requirements
• Develop and maintain repositories for quality related data, including internal and external data
• Complete groundwork requirements, such as, but not limited to, evaluating state or federal priorities, performing market research and completing epidemiological studies
• Review current and prospective contracts, work cross functionally with other SMEs and writers to collect required supplemental documentation, appendices and forms
• Proofread proposal documents and make revisions, as necessary
• Complete Model of Care SNP documentation such as Population Assessment and Quality Improvement requirements
• Support proposal compliance efforts through compiling success stories and metrics for RFP content inclusion
• Collect proposal commitments related to quality improvement and work cross-functionally to implement.
• Work with the Implementation team and the Enterprise Project Management team in the successful implementation of new markets and lines of business.
• Develop and maintain Quality & Performance Organization’s implementation project plans based on contractual requirements and RFP commitments. Develop new market quality related governing documents (Trilogy documents, policies and procedures, other contractually required programs)
• Support other quality functional areas in the development and execution of new market and product implementations.
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s degree or equivalent years of relevant work experience required
• A minimum of five (5) years of Managed Care Experience, preferably within Quality Management/Improvement
• Experience with RFPs and new business implementations is required
• Experience with Managed Care content writing is required

Competencies, Knowledge and Skills:

• Proficiency in Microsoft Office tools, including Power point, Word, Excel, Teams and Outlook
• Demonstrates critical thinking, analytical and timely in problem solving skills
• Demonstrates interpersonal and relationship building skills
• Ability to effectively interact with all levels within the organization
• Demonstrates effective written and verbal communication skills
• Strong knowledge of Managed Care and Quality Management, including NCQA accreditations
• Ability to work independently and with within a team environment

Licensure and Certification:

• Current CPHQ is preferred

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Travel up to 25% may be required per year

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.