Manager of Quality Incentive Programs

Partnership HealthPlan of California•Fairfield, CA

About The Position

The Manager of Quality Incentive Programs is responsible for managing Partnership HealthPlan’s Primary Care, Hospital, and Long Term Care Quality Incentive Programs, also known as Quality Improvement Programs (QIPs). The QIPs provide financial incentives, data, and technical assistance to our provider network for meeting performance improvement targets. As part of this work, the position oversees Partnership’s Provider Data Portal which allows providers to evaluate their performance and obtain data to manage their patients and ultimately improve care.

Requirements

Bachelor’s degree is required; Master’s degree in healthcare is strongly preferred.
At least four (4) years of experience in project management related to healthcare.
Prior supervision of staff is required.
Advanced data analytic skills.
Knowledge of healthcare quality data.
Understanding of improvement measurement and analysis using run charts (trending data over time), and making decisions based on these data.
Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business.
Strong written and oral communication skills.
Strong organization skills to work on multiple projects simultaneously within established time frames.
Ability to plan, implement, and report on quality management projects.
Strong analytic and critical thinking skills.

Responsibilities

Provides oversight, mentoring, and coaching to the QIP team in the following areas: Development and implementation of communication plans and presentations to Partnership’s leadership and physician committees;
Strategic leadership to all QIP programs including experience formulating objectives and priorities and implementing plans consistent with long term views/vision. Capitalizes on opportunities and effectively manages risks;
Provides direction to the planning, implementation, and evaluation of all components for quality incentive programs;
Provides advice and support on quality incentives programs run through other Partnership departments, such as, the pharmacy 340B QIP, the mental health QIP, and the specialty QAIP;
In conjunction with the Partnership leadership team and community stakeholders, develops other pay for performance programs, as needed;
Works collaboratively with IT and Health Analytics departments on the data systems to support regular measurement and feedback on the QIP measures;
Researches and advises on program, payment, and incentive methodologies for quality incentive programs;
Models data-driven leadership, ensuring interventions are measured and evaluated for efficacy and impact;
Understands and exhibits expert knowledge in the various components of the QIPs.
In conjunction with the Director of QI/PI and the CMO, oversees the development, implementation, and evaluation of the Provider Data Portal:
Works with Partnership departments, business analysts, and providers to gather business requirements through observation, interviews, and facilitated questions;
Works with business analysts, vendors, and IT department to develop prototypes for the portal;
Oversees the testing, implementation, long-term management, and continuous improvement of the portal;
Oversees the data integrity and reporting from the portal by ensuring data management and validation processes are in place;
Provides direction to the team on all aspects of the portal.
Leads a high performing team:
Supports the development of the QIP and Provider Portal teams by establishing clear goals, expectations, and metrics to ensure that they are used to continually motivate staff and support meeting department goals and objectives;
Hires, trains, coaches, supports, and directly supervises QIP staff. Regularly assesses staffing needs and advocates for additional staff as required.
Serves as member of QI Department and Health Services Management Teams:
Supports QI Department Director in budget management, staffing decisions, and strategic and operational planning;
Collaborates with department director and QI management team to ensure alignment of efforts across the department. Helps develop and manage communication feedback loops so work from other areas (i.e. QIP programs, HEDIS, analytics, regional offices) informs QIP and Data Portal priorities, and vice versa;
Collaborates extensively with QI staff in Redding office to foster alignment and cohesion across QIP, provider data portal, and other QI department functions;
Attends Health Services Management Team meetings and stays informed of critical work across Health Services department. Advises of Health Services department strategy and continually assesses and adjusts operational plan of QIP team to support this larger strategy;
Works with other directors and managers across the QI department and Partnership as a whole on data and measurement related activities, including the Quality Improvement Program, Partnership Stars Dashboard, provider reporting tools, and internal dashboards and program evaluations.
Stays informed on key developments in the quality improvement field that impact our provider network, including patient-centered medical home certification criteria, meaningful use, primary care transformation best practices, and quality reporting requirements.
Stays informed of key developments and research in the area of Pay for Performance.
Assures that processes for Quality Improvement projects are HIPAA compliant and implements any needed changes or upgrades.
Accepts other responsibilities as determined by the needs of the QI Department.