Quality program manager job description

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Overview
The Program Manager, Quality Strategies is responsible for overseeing the development and execution of strategies, solutions and initiatives to maintain and improve Independent Health's performance related to quality management including, but not limited to HEDIS, QARR and Star. This role will participate in the development, revision and appraisal of the annual quality improvement work plan. This role will also participate in the planning, development and coordination/facilitation of performance improvement activities within the Population Health Management/Health Care Service departments and across functional areas to assure the integration of quality improvement initiatives in support of the health plan's achievement of Quality goals. Program timeliness and deliverables are communicated to appropriate parties and are consistently achieved.

The Program Manager will perform rigorous business analysis of plan performance against peer plans and industry benchmarks to identify improvement areas. The program manager will leverage both evidence-based and industry best practices to recommend efficient and effective strategies and solutions to address areas of identified opportunity. The program manager will design and facilitate the development, execution, and measurement of initiatives following improvement science methods. The program manager will work with other team members and organizational staff as assigned and shall function to promote teamwork and accountability in a performance-based work environment.

Qualifications
Bachelor's degree required. Masters' degree preferred. Certified professional in health care quality (CPHQ) or certification in Lean or Six Sigma preferred.Five (5) years of experience in healthcare quality data analysis to include two (2) years of project management experience required. Managed care experience strongly preferred.Two (2) years of progressive leadership experience/responsibilities required.Ability to define problems, collect data and draw valid conclusions. Strong business analytics skills. Experience in facilitation preferred.Knowledge of emerging technologies, healthcare improvement strategies, and evolving reimbursement mechanisms strongly preferred.Solid understanding of at least one of the following preferred: NCQA standards, NYSDOH/CMS regulations and HEDIS measures .Experience in developing, implementing and evaluating clinical quality improvement programs required. Solid understanding of improvement science methods (e.g., Lean, Six Sigma, Plan-Do-Study-Act) and quality improvement techniques preferred.Demonstrated ability to analyze business data and deliver timely, accurate and relevant reports.Working knowledge of campaign management best practices strongly preferred. Excellent verbal, written and interpersonal skills required.Excellent PC skills required (Word, Excel, Access, PowerPoint). Experience using quantitative analytical tools (e.g., SAS, SPSS) preferred.Local travel may be required. Any Independent Health associate who uses a motor vehicle in the course of their duties representing Independent Health must be compliant with New York State Motor Vehicle laws and must follow the Policy that pertains to Driver's License Requirements as a condition of employment.Ability to work a flexible schedule required.Demonstrated time management skills, with the ability to work in a self-directed manner.Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Essential Accountabilities
Responsible for contributing to the strategy development, coordination, measurement and ongoing monitoring of quality assurance and performance improvement roadmap initiatives, including annual work plans and evaluations.Works collaboratively with stakeholders to identify opportunities for improvement and development of appropriate action plans for problem resolution. Proactively provides best practices in determining the design and implementation of initiatives to achieve goals both member, provider, and delivery system interventions.Oversees execution of initiatives using improvement science best practices and works closely with stakeholders on their accountabilities. Accountable for managing critical performance objectives and quality/performance improvement measures per the work plan.Analyzes and trends quality rates using best practice analytic methods, identifies barriers to improvement of rates, and communicates findings to stakeholders through creating interpretive exhibits and storytelling. Active participant on the Quality Trend Team, Quality Performance Committee, and HEDIS team. Partakes in professional work groups, quality improvement projects and committees as assigned. Participates in various plan activities, including but not limited to, conferences, health fairs, etc.Assures departmental compliance with regulatory and accreditation standards.Oversees staff as assigned. Develops, coaches and mentors assigned team members.Develops appropriate objectives and metrics to measure team productivity. In collaboration with department leadership, identifies opportunities for professional growth and development in order to achieve departmental efforts in support of strategic goals.Responsible to develop and implement process improvements to gain/maintain departmental efficiencies.Facilitate communication to staff regarding ongoing corporate initiatives by representing the department in cross functional meetings and assist in the decision making process to ensure that the needs of the department are being met.Manages within financial budget.

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via their Career Worklet.

1035 Cambridge Street
Work Days: 8-5
Category: Professional and Management
Department: Quality Management
Job Type: Full time
Work Shift: Day
Hours/Week: 40.00
Union: No
Union Name: Non Union
DEPARTMENT DESCRIPTION:
The Division of Quality is responsible for promoting a culture of safety, patient and staff engagement, and performance excellence aligned with national patient safety goals.
Summary:
The Quality and Safety Department serves as a resource center to the organization to cultivate a culture of safety, eliminate preventable harm for all patients and staff, provide high value, equitable, evidence-based care, create an excellent care experience and to develop institutional capacity in improvement science and promote data-driven decision making. Join our talented team to contribute towards the mission of our organization.
The Cambridge Health Alliance is joining the American College of Surgeons National Surgical Quality Improvement Program and is in need of a certified Surgical Clinical Reviewer who will work both independently and in collaboration with the surgery leadership committees, and other members of the health care team to track surgical outcomes, analyze data, and identify opportunities for clinical quality improvement and other special projects. The Surgical Quality Program manager will re-certify each year and will monitor ACS NSQIP compliance, and be the CHA liaison to the ACS NSQIP program.



Responsibilities:
Apply specialized, clinical knowledge to hospital partners: categorize, code, summarize, interpret and calculate registry/case information from patient medical records.
Ensure quality submission of all data in specified registries or measure data repositories, maintaining a high accuracy threshold.
Prioritize, organize, and meet tight deadlines for multiple concurrent tasks and team requests; uses tact and judgment to manage expectations, flag obstacles and propose solutions in a timely manner.
Oversee quality reporting systems within the Department of Surgery, and produces reports monthly, quarterly, annually and ad hoc to meet the needs of the department. Monitors and ensures data integrity of reports.
Contribute to team best practices, data dictionaries, abstraction guidelines, and other business rule documents; identify process improvement opportunities to help streamline tasks and processes.
Keeps up to date on mandated regulatory/publicly reported data requirements as specified by federal, state, payer and other agencies.



MINIMUM QUALIFICATIONS:
Direct clinical data abstraction experience within NSQIP
Have an active SCR certification

Education/Training:
Bachelor's degree, BSN prepared RN, relevant experience may be substituted for a degree.

Work Experience:
Three to five years of surgical related experience.

Essential Skills:
Strong analytical and critical thinking skills to approach problems in a systematic method using the ability to synthesize data and suggest recommendations
Proficiency in EPIC, Google Workspace (Google sheets, docs, slides, Smartsheet), Microsoft Office Suite (Word, Excel, Access, PowerPoint), and LucidChart, Ability to demonstrate analysis using graphics.
Demonstrates high standards for accuracy and attention to detail
Thrives working independently and takes ownership of projects/patient records
Consistently and clearly communicates, adjusting style and tone as needed to effectively collaborate with a variety of constituencies both internal and external to the organization.
Demonstrates strong self-organizational and time management skills to concurrently manage multiple projects, adjusting as needed to shifting timelines and priorities
Maintains a high degree of responsibility in keeping PHI secure and confidential



In keeping with federal, state and local laws, Cambridge Health Alliance (CHA) policy forbids employees and associates to discriminate against anyone based on race, religion, color, gender, age, marital status, national origin, sexual orientation, gender identity, veteran status, disability or any other characteristic protected by law. We are committed to establishing and maintaining a workplace free of discrimination. We are fully committed to equal employment opportunity. We will not tolerate unlawful discrimination in the recruitment, hiring, termination, promotion, salary treatment or any other condition of employment or career development. Furthermore, we will not tolerate the use of discriminatory slurs, or other remarks, jokes or conduct, that in the judgment of CHA, encourage or permit an offensive or hostile work environment.

• Bachelor’s degree in a Health Care, Engineering, or Performance Improvement field or equivalent.
• Possess a minimum of 5-7 years’ experience in a healthcare, performance improvement, project management, or other advanced position.
• Exceptional communication and interpersonal skills with all levels of staff, including physicians and administrative staff.
• Experience facilitating groups with many different stakeholders
• Ability to elicit cooperation and maintain productive working relationships with internal and external leaders.
• Knowledge of performance improvement techniques and methodologies.
• Ability to lead complex, interrelated portfolio of projects, using program management tools and techniques.
• Ability to set strategic vision for portfolio/ program and is accountable for all quality-related operations and goals in the focus area to have a major impact on clinical operations and outcomes in that area.
• Ability to manage, interpret, and present data.
• Self-motivated: given appropriate direction for goals, must be able to work autonomously in a sometimes ambiguous and changing environment

Preferred Qualifications:

• Master’s degree in Public Health, Health Care Administration, Business Administration, Nursing, or another health care-related field.
• Possess a minimum of 5-7 years’ Performance Improvement experience in Hospital, or large Health System.
• Experience with clinical terminology.

Position Details:

• Job Type/FTE: Full Time (1.0 FTE)
• Shift: Days – 8 hour shift
• Unit/Department: Quality Performance Improvement
• CBA Code: Non-Union

In this role, we anticipate that you will generally work approximately 40 hours per week. We anticipate that you will generally be scheduled to work the first shift, from approximately 8am-5pm and will not be scheduled for on-call shifts. The days of the week that you are scheduled will be Monday-Friday

Must comply with UCMC’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.