Manager Clinical Quality Improvements
Manager Clinical Quality Improvements
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Salary Not Disclosed
1 Vacancy
Job Description
Overview
***This position is remote/work from home within California.
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
Responsibilities
***This position is remote/work from home within California.
This position will lead a team of dedicated LVNs/RNs in support of organizational quality improvement initiatives across Medicare Medicaid and Commercial space. He/She will partner with other departments health plans and providers to develop and monitor quality improvement plans and report out to leaders. This position offers the opportunity to not only engage at the local level but also engage at a system/national level in the population health space.
Position Summary:
The Manager Clinical Quality Improvement is responsible for leading multiple large scale local or organization-wide quality improvement initiatives. This position is also responsible for negotiating timelines and priorities for projects coordinating action plans and monitoring/analyzing results for projects that are consistent with the organizations strategic goals. The Manager Clinical Quality Improvement will oversee the day-to-day management of the QM department acts as a liaison between the MSOs medical groups and contracted health plans works collaboratively throughout the organization to lead and establish appropriate quality improvement programs.
Responsibilities may include:
- Provides expertise in the interpretation implementation and maintenance of regulatory standards (e.g. DMHC DHCS CMS NCQA).
- Stays abreast of quality measures and industry best practices to optimize performance.
- Creates or updates Policies and Procedures to ensure compliance with regulatory requirements.
- Leads the identification of improvement opportunities and solutions to improve quality. Coordinates facilitates and ensures sustainability of quality initiatives.
- Performs data analysis to drive actions based on data-driven insights.
- Defines expected outcomes & benchmarks based on quality in the development of meaningful dashboards and tools to track process and outcome measures (Provider Score Cards Gaps in Care reports).
- Designs workflows disseminates data and communicates shared learning.
- Perform other duties and special projects as assigned.
Qualifications
Minimum Qualifications:
- CA Clinical licensure (Registered Nurse (RN) Licensed Vocational Nurse (LVN) Licensed Clinical Social Worker (LCSW) NP PA).
- 5 years of Quality Management (QM) experience in managed care health plan setting or medical group.
- 5 years of oversight/supervision/management/leadership of clinical and non-clinical quality management staff.
- 3 years HEDIS measures reporting and experience in CMS Stars P4P ACO and Value Based Payment Programs.
- 3 years Medical record review project management.
- Bachelors degree or equivalent in health sciences or related field.
Preferred Qualifications:
- 2 years of clinical experience in an acute care setting long term care facility or home health care strongly preferred.
- Masters degree (MPH MPA MA) strongly preferred.
- Certification in Health Care Quality and Management (CHCQM) or Certified Professional in Health Care Quality (CPHQ) strongly preferred
- LEAN or Six Sigma Greenbelt strongly preferred
#LI-DH
Required Experience:
Manager
Employment Type
Unclear
