HarmonyCares · 9 hours ago
Senior Manager – Quality Improvement CHA
United States
Full-time
Remote
Mid, Senior Level, Lead/Staff
$110K/yr - $130K/yr
4+ years exp
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Responsibilities
Perform analysis of organizational needs related to successful quality programs for Comprehensive Health Assessment line of business
Work as a liaison to payer partners to ensure quality improvement activities achieve outcomes and report in a way that ensures contract compliance
Ensure annual compliance with changes across HEDIS/STARS technical specifications, policies, and operating procedures in EHR and Specialty Programs reporting as they are made by governing bodies
Partner with Quality analyst to ensure compliance with data submissions, validation audits, and reporting expectations across payer relationships
Lead & manage multiple quality improvement programs, including initiatives that support quality gap closure, clinical quality education, and clinical toolset optimizations
Manage patient satisfaction survey readiness, operationalization, and outcome remediation
Lead in the development, monitoring and review of Key Performance Indicators (KPI)
Responsible for research, identification and implementation for all change management needs for new or existing quality measures and/or contract requirements
Evaluate, problem solve, perform root cause analysis and provide possible solutions to quality issues across all disciplines
Provide oversight in gathering, organizing, & evaluating relevant information regarding all quality measures, specifications, coding changes, documentation alignment, and working closely with all services lines for these changes for established and ongoing changes
Convert the functional requirement into the technical requirements with quality measures, EHR documentation, data analytics, and other requirements
Assist and/or manage creation of presentations, program requests and implementation, builds of presentations, requests from other departments, perform analysis of determining need for involvement of other departments
Act as the interface between the quality department, IT technical staff, Data Analytics, Third Party Vendor(s), and other departments for all changes, builds, tracking and monitoring of data and mapping with the EHR system and Third-Party Vendors
Coordinate with internal partners for any data issues and discrepancies found during audits to resolve issues and manage escalations as needed
Provide coordination on payer agreements and ensure discrepancies with external reporting are addressed in a timely manner
Qualification
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Required
Bachelor’s degree in healthcare administration, public health, health service administration, business administration or related healthcare field
4+ years of healthcare experience, preferably in a primary care or managed care setting
3+ years of project management experience
2+ years of experience in working with ACO, HEDIS, and/or Star measuring data requirements
Proficient in using Microsoft office applications, including databases, word-processing, and excel spreadsheets.
Ability to communicate in an empathetic, compassionate, and professional demeanor at all times
Ability to problem solve with demonstrated capacity to embrace complex problems and arrive at effective solutions in a timely manner
Ability to analyze problems and resolve issues in a rapid, direct and complete manner
Ability to adapt to new systems and changes as required and apply guidelines/procedures
Excellent communicator with an uplifting and personable manner with outstanding phone etiquette
Excellent written communication skills with success in providing notes, updates, and written communications via computer systems
Demonstrated written and verbal communications skills
Ability to work in a fast-paced, healthcare environment
Ability to multi-task while given competing priorities
Preferred
2+ years of experience working with clinic operations, preferably primary care
2+ years of experience in IT systems analyses, including but not limited to: electronic medical records, reporting systems, and HEDIS engines
Benefits
Health, Dental, Vision, Disability & Life Insurance, and much more
401K Retirement Plan (with company match)
Tuition, Professional License and Certification Reimbursement
Paid Time Off, Holidays and Volunteer Time
Paid Orientation and Training
Company
HarmonyCares
Established in 1993, HarmonyCares, formerly U.S. Medical Management LLC (USMM), offers comprehensive home-based healthcare services.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Elissa Estopinal
VP, Chief of Staff to the CEO
Matthew Chance
Chief Executive Officer
Company data provided by crunchbase
