Manager of HEDIS

AboutPriority Health

We arethe second largest and fastest growing health plan in Michigan focused on improving the health and lives across the state and we couldnt do it without the incredible talent of our employees. It is their commitment that continues to drive our success as a nationally recognized nonprofit health benefits company. As part oftheCorewell Health system our team members have a unique ability to grow and advance their career while maintaining their seniority and benefits.

Scope of Work

This role will directly support current HEDIS operations as well as the emerging and critical new work associated with the Priority Healths Stars and Quality Programs. This role will be responsible for daily HEDIs operations tied to retrospective HEDIS and rates submissions to NCQA. Additionally this role will support new work associated with Priority Healths company growth and expansion. Manages the Quality and Senior Quality Improvement Specialists and their work. Responsible for the creation implementation and management of the Quality Department projects and the formation of clinical improvement teams. This work includes the assessment analysis planning implementation and evaluation of a large number of interventions programs and data. Additionally the role includes consultation within the health system in planning group processes targeting improvement strategy initiatives and for facilitating change through internal team building.

Essential Functions

• Supports quality improvement activities with annual project plans outlining measurable deliverables and quarterly milestones ensuring services are provided in accordance with state and Federal regulations organizational policy and procedures medical staff by-laws and accreditation / compliance requirements.

• Expertise in leading team activities in a manner that is organized but fosters creative thinking and activity. Identifies and monitors project scope target timelines resource requirements cost milestones data requirements and completes documents and reports as necessary.

• Manages the work priorities of the Quality Improvement Department on high volume high cost and high-risk projects. Delegates the general work assignment areas for all employees and assigns special projects individually. Mentors coaches and develops employees while being a role model and resource to them.

• Responsible for interviewing hiring retaining employees and members of the team monitoring performance monitoring. Initiating when appropriate follow through with disciplinary action and termination in consultation with Human Resources for service. Mentors coaches and develops employees and developing Smart Objectives.

• Expert in communicating team results on a routine basis to management and key players in a timely and complete manner. Maintains knowledge of team activities and keeps strict confidentiality as appropriate. Has expertise in process improvement theory and strategies data analysis and change theories. Shares key learnings with others and fosters direct and honest communication.

• Manage and coordinate the development and implementation of patient safety culture behaviors and initiatives within the physician clinical practice.

• Networks with peers in the field and ensures that all services are provided in a manner consistent with state and Federal regulation organizational policy accreditation and/or compliance. Knows and support key organizational strategies and incorporates them into team strategies. Maintains knowledge of current trends and developments in the field by reading appropriate books journals and other literature and attending related conferences seminars etc.

Qualifications

• Bachelors Degree or equivalent in health care engineering case management business administration. Required

• Masters Degree or equivalent. Preferred

• 7 years of relevant experience skills knowledge abilities typically gained through 7 years of related health care business or quality improvement experience. Required

• 3 years of relevant experience leading others. Required

• Experience with multidisciplinary teams in a complex healthcare system. Preferred

• At least one Certification - Institute for Healthcare Improvement (IHI). preferred

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial health and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you like restaurants phone plans spas and more!

• Optional identity theft protection home and auto insurance pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

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CURRENT COREWELL HEALTH TEAM MEMBERS Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members patients visitors and community. We require a drug-free workplace and require team members to comply with the MMR Varicella Tdap and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process to perform the essential functions of a job or to enjoy equal benefits and privileges of employment due to a disability pregnancy or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race color national origin sex disability age religion genetic information marital status height weight gender pregnancy sexual orientation gender identity or expression veteran status or any other legally protected category.

An interconnected collaborative culture where all are encouraged to bring their whole selves to work is vital to the health of our organization. As a health system we advocate for equity as we care for our patients our communities and each other. From workshops that develop cultural intelligence to our inclusion resource groups for people to find community and empowerment at work we are dedicated to ongoing resources that advance our values of diversity equity and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.