Quality Practice Manager QPM Las Cruces Physician Services
Quality Practice Manager QPM Las Cruces Physician Services
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1 Vacancy
Job Description
Minimum Qualifications
- Minimum Education: High School Diploma or equivalent required. Bachelors degree in Business Healthcare Administration or related field of study; or an equivalent combination of education and/or experience.
- Minimum Experience: Three 3 years of experience in the healthcare industry; preferably with healthcare network operations and/or practice management.
EEOC Statement
Memorial Medical Center is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color race sex age religion national origin disability genetic information gender identity sexual orientation veterans status or any other basis protected by applicable federal state or local law.
Who We Are
People are our passion and purpose.Come work where you are appreciated for who you are not just what you can do. Memorial Medical Center is a199bed hospital offering a spectrum of care including diagnostic therapeutic and rehabilitative services both on an inpatient and outpatient basis.
Where We Are
From national parks and monuments to one of the toprated farmers markets in the country Las Cruces offers a world filled with natural wonder yearround excitement and historic proportions of fun. We are known for our safe and affordable living conditions outstanding educational system and friendly people.
Why Choose Us
- Health (Medical Dental Vision) and 401K Benefits for fulltime employees
- Competitive Paid Time Off / Extended Illness Bank package for fulltime employees
- Employee Assistance Program mental physical and financial wellness assistance
- Tuition Reimbursement/Assistance for qualified applicants
- Professional Development and Growth Opportunities
- And much more
Position Summary
Memorial Physician Practices consist of 8 primary carebased clinics and 15 Clinicians including a Family Residence program. In 2019 and 2020 insurance payers have been establishing databases and collecting quality data on MPP providers to position and leverage MPP towards qualitybased contracts. In 2021 MPP will proactively work with insurance payers such as UHC Presbyterian BCBS Western Sky and Humana to maximize quality incentive programs. In addition to quality incentive dollars the implementation of MPP will increase volumes in PCP visits colonoscopies cervical cancer screenings and mammograms.
The Quality Practice Manager (QPM) will collaborate with employed practices to achieve local objectives for Memorial Medical Practices through ongoing education training and support activities. The QPM establishes and maintains practice/provider relationships presenting practices HEDIS STARS and RAF training and planning and contract performance monitoring with the ultimate goal of optimizing practice performance in a valuebased and/or riskbased environment.
This position collaborates with Credentialing Care Management technology platform and payer representatives as appropriate.
Responsibilities:
Collaborate with various practices and departmental leaders to accomplish workload requirements.
Support activities to achieve the overall strategy and objectives of the Practice Performance department.
Serve as the primary point of contact and conduit for all other subject matter experts that need to interface with the practice and its staff.
Responsible for developing and strengthening relationships with various provider groups while serving as the primary contact for the assigned providers and practices.
Onboarding Education and Training.
Payer contract offerings.
Strategic network communication.
Performance reports and scorecards Implementation of Equality Health technology.
Introduction to other Equality Health teams as appropriate.
Work closely with Practice Managers Directors and Executive team to identify provider issues and escalate to develop and implement a course of action for resolution.
Responsible for accurate documentation and maintenance of provider information within electronic medical record.
Ensure the collection and maintenance of contracts and provider and practice information.
Identify opportunities for process improvement and facilitate issue resolution Identify and provide recommendations for provider participants quality and utilization improvement plans and assist practices in the development implementation monitoring and tracking of contract goals and activities.
Monitor the overall performance of the practice and its providers to ensure that there is compliance.
Deliver operational reports (scorecards) to the practice/providers and initiate oneonone meaningful interactions regarding current performance.
Utilize professional clinical and/or quality improvement experience and expertise to guide the practice.
Support new business growth by helping to identify opportunities for developing primary care provider and/or specialist leads to close gaps in network services and access.
Perform other responsibilities as assigned for special projects and escalated issues.
Demonstrated understanding of risk and valuebased contracting.
Demonstrated knowledge and experience with primary health care practice standards and quality performance measures STARS and HEDIS.
Excellent verbal written and interpersonal communication skills; highly collaborative team approach to work.
Proficiency with Microsoft Office applications and webbased technologies Strong provider relations skills and experience.
Familiar with payment alternatives such as fee for service capitation global budget performance compensation and episode of care payment Familiar with patient and practice risk adjustment mechanics and premiumbased payment methodologies.
Familiar with patient and practice risk adjustment mechanics APR; HCC/RAF Familiar with conventional payment methodologies (CMSRBRVS).
Experience with database management in a healthcare setting Demonstrated ability to gain acceptance and compliance from provider and staff and achieve a mutually beneficial outcome.
Excellent problemsolving skills including the ability to systematically analyze problems draw relevant conclusions and devise appropriate courses of action.
Able to convey complex or technical information in a manner that others can understand and able to understand and interpret complex information from others.
Successful record of managing multiple projects with demonstrated ability to work independently in rapidly changing environments.
Required Experience:
Manager
Employment Type
Full-Time
