Manager, Quality Improvement

US-CA-Los Angeles
Job ID
2017-4774
Category
Quality

Overview

Under the direction of the Medical Director of Quality, this position is responsible for managing clinical quality analysts in the design, implementation and evaluation of AltaMed’s quality program and improvement strategies.  The manager will oversee data collection, analysis, evaluation and reporting for both internal purposes and external entities. The manager will serve as liaison to all corporate departments and external networks to ensure efficient workflows, improve quality of care documentation and outcomes, align strategic efforts, and ensure accurate quality reporting.  Assimilates information to proactively develop quality activities and metrics aligned with company strategies and values while linking the quality management activities to business goals. Serves as a resource and Subject Matter Expert (SME) on outcomes measurement and analysis aspects of the quality program to develop and influence business strategies. Additionally, this position will work with Managed Care, Information Technology, Balanced Scorecard, Clinical Informatics, Nursing, and Operations to develop, implement, and evaluate health outcomes (i.e., HEDIS) and performance measures (i.e., patient satisfaction) pertinent to improvement in all patient-centered care.

 

 

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Responsibilities

  1. Oversee the provision of processed data analytics to providers and clinic staff, reports on performance improvement and quality of care and service interventions and efforts.
  2. Work with the Medical Director of Quality to identify quality of care and patient experience issues.
  3. Track and trend specified patients/population/conditions that support the clinical and care management of these patients.
  4. Support quality improvement projects and initiatives –overseeing planning  of the Clinical Quality Improvement Committee (CQIC)
  5. Supports QPID in service, process and quality improvement efforts to ensure standardization and integration between programs.
  6. Participate in strategic planning in anticipating market needs and develop innovative responses to address future needs and challenges through planning and management of QI. Acts as member on various QI and Operations committees to ensure strategic alignment and effectiveness.
  7. Formulate recommendations on program efficiencies and effectiveness, lead Quality Performance Improvement Department (QPID) in developing annual reports on AltaMed’s Healthcare Effectiveness Data and Information Set (HEDIS), Health Resources and Services Administration (HRSA), and Industry Collaborative Effort (ICE) Quality and Utilization Work Plans for health plan reporting and compliance.
  8. Distributes and interprets reports related to the respective programs supported.
  9. Keep abreast of industry changes and serves as a subject matter expert on programs affecting quality, population health, and incentive programs.
  10. Performs process improvement analysis and prepares/presents related documents for health care clinics. Support the development of QI, project tools, and policies and procedures with system wide implication.

Qualifications

  1. Master’s Degree Business Administration, Health Administration, Social Worker, Public Health is required.
  2. Advanced certification or licensure in health care or process improvement is desired (LVN, RN, SW, Project Management, LEAN, or Six Sigma).
  3. A minimum of 3 years prior experience in an acute and ambulatory healthcare environment performing process improvement duties and has knowledge of Joint Commission or NCQA Accreditation processes and requirements are preferred.

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