Quality, Performance Improvement Manager
Trinity Health
**Employment Type:**
Full time
**Shift:**
Day Shift
**Description:**
**GENERAL SUMMARY AND PURPOSE:**
The Manager of Quality Performance Improvement serves as a key member of the Saint Alphonsus Medical Group. This position manages a team of quality improvement clinical staff and or other non-clinical on the population health team.
This manager works collaboratively Saint Alphonsus Medical Group [SAMG] providers, health plan payers, Senior Leadership Team (SLT), promote wellness and quality outcomes for our community of patients. This role will optimize patient experience, identify performance improvement opportunities, and support and lead performance improvement initiatives under the direction of the Director of Quality and Population Health. Through collaboration and educational support, this position will play a key role in empowering providers to maximize the value of care provided to the patients, provide service excellence to the organization, and reduce the total cost of care.
**SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:**
Must possess knowledge normally acquired through the completion of a bachelor’s degree in business or healthcare related field, with two (2) or more years of related experience; or equivalent combination of education and experience **.** Experience working in a health system, hospital, medical practice or payer organization preferred. Physician practice management experience preferred. Working knowledge of health care business practices, physician practice workflow, provider billing, risk coding and payer contracting preferred gained through experience.
Experience working in a quality and/or performance/process improvement role preferred. Knowledge of NCQA and HEDIS standards and Medicare Advantage Star ratings gained through experience preferred. Experience analyzing and identifying performance improvement opportunities using quality, cost and utilization data preferred.
**ESSENTIAL FUNCTIONS:**
Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions. Develop an expert-level knowledge of performance measures (e.g. quality, utilization, cost, care coordination, etc.), performance improvement initiatives and performance improvement methodologies. Educate providers, practice managers and other members of the healthcare team on performance measures (e.g. quality, utilization, cost, care coordination, etc.), performance improvement initiatives and performance improvement methodologies. Able to perform presentations to providers educating Quality HEDIS performance standards, areas of opportunities, and or initiatives to drive performance. Prepare and distribute educational materials for providers and clinic staff.
Support and perform as necessary outreach to current members (e.g. facilitating establishment with a primary care provider, supporting scheduling appointments for care gap closure, etc.). Prepare and distribute patient rosters to practices on a monthly basis. Support data collection, input, and reporting for all performance improvement programs. Prepare and analyze monthly/quarterly practice gaps in care and performance reports. Serve as a liaison for practice inquiries (e.g. attribution, gap closure, quality scores, etc.). Prepare and analyze performance dashboards for SAMG SLT or Committee meetings. Validate the accuracy of payer performance reports and communicate discrepancies Identify process improvement opportunities within practices.
Develop, document, execute, track and communicate progress in relation to practice based performance improvement plans/initiatives. Collaborate with clinics to optimize documentation, data capture performance improvement initiative related workflows. Support and participate in SAMG meetings as directed. Support and participate in performance meetings with payers as directed. Collaborate with payer partners to: assess practice and provider performance; identify opportunities for improvement; and coordinate improvement Establish, influence, and manage internal and external cross-functional relationships to ensure the effective execution of Alliance initiatives. Meet and adhere to established confidentiality, productivity and quality standards. A personal presence characterized by honesty, integrity, and caring required that promotes the philosophy, mission, vision, goals, and values of SAMG and Trinity Health required. Strong project management and organizational skills required. Proven ability to complete large, complex projects in an accurate, timely and autonomous fashion required. Strong analytic skills required.
Excellent verbal and written communication skills including a proven ability to make clear, concise presentations that inspire and motivate others required. An understanding of the fundamentals of patient-centered health care preferred. Collaborative and comfortable operating in a shared leadership environment. Demonstrate ability to function effectively in a dynamic, fast-paced environment. Demonstrate customer focused interpersonal skills to interact in an effective manner with patients and families, practitioners, the interdisciplinary health care team, community agencies, payers, with diverse opinions, values, religious and cultural beliefs. Demonstrate ability to work autonomously and be accountable for outcomes. Other duties as assigned.
Colleagues of Saint Alphonsus Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout SAHS and Trinity Health.
Visit www.saintalphonsus.org/careers (https://www.saintalphonsus.org/careers/search-openings/details?j=00137722\_Speech%20Therapist%20PRN) to learn more about the benefits, culture and career development opportunities available to you at Saint Alphonsus Health System.
Saint Alphonsus and Trinity Health are committed to promoting diversity in its workforce and to providing an inclusive work environment where everyone is treated with fairness, dignity and respect. We are committed to recruit and retain a diverse staff reflective of the communities we serve. Saint Alphonsus and Trinity Health are equal opportunity employers and prohibit discrimination against any individual with regard to race, color, religion, gender, marital status, national origin, age, disability, sexual orientation, or any other characteristic protected by law.
**Our Commitment to Diversity and Inclusion**
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
EOE including disability/veteran
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