Manager, Quality

Clarity on the Role

Quality Managers require a deep understanding of CMS measure technical specifications and previous quality experience. These qualifications will ensure that the Quality Strategy is implemented and continued as designed. The Quality Manager will be the main point person for not only the Partner Success team but partners for each designated region, ensuring even workload split and continuity with partners. The Quality Manager will be responsible for the following :

• Obtain and analyze the baseline assessment of clinical and EHR workflows of each assigned partner
• Work with partners as needed to further develop workflows and ensure documentation meets unique reporting requirements
• Ensure partners are knowledgeable with the Wellvana Universal Measure Set and how that differs from their end-of-year reporting requirements
• Monitor performance monthly through a standard reporting package, develop actionable next steps for discussion with partners for continuous improvement
• Data Optimization
• Performance Enablement
• Deliver and assist with interpretation of technical requirements needed for each program to ensure optimal performance
• Ensure supplemental data is uploaded to payor portals as applicable
• Deliver strategies that utilize established industry best practices and clinical pathways to meet and exceed measure benchmarks through utilization of multiple educational platforms and techniques
• Webinars
• Educational Content Development (e.g. Quality Measure guidebook)
• 1 : 1 educational support
• Ongoing education of the Partner Success Team and Growth team around annual metric changes to ensure successful engagement of both internal and external clients around quality programs
• Partner with internal teams to successfully deploy ACO REACH / PC FLEX data reporting (previously HEDR)
• Special projects as assigned (e.g. MIPS for Prospective Partners)
• Attend JOCs, monthly quality calls, and monthly action planning meetings as appropriate
• Collaborate with external vendor to ensure end of year quality reporting is evaluated and submitted based on based overall score for each ACO

Requirements

Education :

Years of Related Experience :

Skills :