Position Title: Quality Improvement & Quality Assurance Manager
Status: Full Time
Position Reports to: Quality, Compliance & Risk Management Director / Medical Director / Operations Director
Position Summary: The Quality Improvement & Quality Assurance (QI/QA) Manager, under the supervision of the Quality, Compliance & Risk Management Director / Medical Director / and Operations Director, will have primary responsibility for directing, assisting and guiding management of the performance improvement initiatives of CMOAR, ensuring regulatory compliance and promoting improved health care outcomes. The manager will work closely with Quality, Compliance & Risk Management Director, Medical Director, and Operations Director to establish a vision and direction for the QI/QA Program within the framework of current regulation, market initiatives, supervise quality patient navigators, best practices, existing program work plans and the network’s strategic plan. The use of health information technology (electronic health records, patient portal, data repository, etc.) and resulting data will be a major component of the QI/QA program. The Manager will remain permanently on-site as the application expert, end user training and support person, and technical support for testing and for maintaining member-managed components of the software. Provides leadership and coordination for improving the organization’s core healthcare functions and evaluating the impact that systems improvements have on patient health; and researches and develops QI/QA training programs that focus on enabling the workforce to achieve and monitor improvements with priority health concerns.
Design, direct and oversee implementation of quality improvement/quality assurance programs with the guidance of the QI/QA Committee.
Maintains appropriate minutes, tracking of outcomes and follow-up items; submitting there to the Compliance Officer
Researches and designs appropriate organization-wide performance and quality training. Coordinates performance management and quality improvement capacity building for all levels of management and employees.
Trains and certifies in-hours performance and quality improvement trainers for various performance and quality improvement training programs.
Assist in hiring and supervises patient quality navigators, achieving UDS/CCALAC/HEDIS measures and internal referrals
Ensures execution of monthly/quarterly clinical peer-reviews
Support member health centers in developing and implementing the necessary teams, tools and care process changes in parallel with individual center efforts to improve patient outcomes and develop innovative approaches to primary care delivery reform.
Participate in the critical analysis of individual center and network aggregate results of existing clinical outcome measures
Work closely with CMOAR implementation staff to ensure that all clinical setup and workflow development is aligned with QI/QA program requirements, goals and objectives.
Participate in on-going development of clinical data repository and dashboard reporting. Participate in provider meetings and perform requested follow-up duties.
Generate reports for the management team on monthly and quarterly basis and other reports requested
Design custom reports in Crystal with the assistance of OCHIN
Assist with the NCQA initiative by providing back-end support such as implementing new workflows, generating reports, participating in meetings and tracking initiatives.
Expected to participate in OCHIN’s and CCALAC QI workgroups.
Perform other duties and responsibilities as requested.
A Bachelor’s Degree in field related to (Health Administration, Public Health, Business). At least 3 to4 years of experience in healthcare setting, specifically in Quality Improvement/Quality Assurance. Candidates with lean six sigma certifications and direct patient care experience is a plus..
Excellent communication and leadership skills to influence and motivate teams in achieving organizational goals and initiatives.
A minimum of 1-2 years of supervisorial experience required.
Experience with various EMR systems
Knowledge of Business Objects, Adobe Acrobat, Reporting Workbench and Crystal Reports
Knowledge of Quality Improvement and Quality Assurance tracking methods
Proficient in Microsoft Office, Word, Excel, PowerPoint, and Teams
Ability to maintain a high degree of confidentiality of employee records and information; awareness of HIPAA and all privacy laws
Must be bi-lingual Spanish; ability to communicate effectively, both verbally and in writing (English/Spanish)
Must have excellent time management, organizing and coordinating skills
Ability to perform simple accounting procedures
Ability to multi-task in a fast pace environment and handle multiple tasks
Observes CMOAR policy/procedures regarding conduct in the work place:
Observe regulations on time card use and reporting.
Maintain attendance as per policy.
Maintain a clean and safe work area.
Observe general Safety/Employee Health policies and procedures including Fire regulations.
Maintain a current annual health screening.
Maintain the privacy and confidentiality of clients with regard to personal records and program issues development.
Display clearly visible identification.
Treats all employees, clients, neighborhood committee members with respect, dignity and in a courteous and professional manner in accordance to non-discriminatory policies and procedures and Union Agreement.
Conduct only works related conversations when clients are waiting for service.
Do not discuss other staff members, policies, problems or medical care in public areas of clinic.
Observe and Applies Clinica’s Dress Code
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