Manager, Quality Performance (2022)

US Heart & Vascular•Franklin, TN

1d•Remote

About The Position

US Heart and Vascular is needing a Remote Quality Performance Manager to join our Value Based Care team. Position Summary: The Manager, Quality Programs leads organizational performance for all quality programs across US Heart and Vascular (USHV). This role is accountable for CMS Merit-based Incentive Payment System (MIPS) and emerging Center for Medicare & Medicaid Innovation (CMMI) models, such as the ASM Model. This role will serve as the subject matter expert (SME) for MIPS, CMS quality programs, value-based care (VBC) contract quality programs, and new VBC initiatives.

Requirements

Proven ability to lead cross-functional teams and drive strategic initiatives
Expertise in data visualization, predictive modeling, and performance measurement
Exceptional communication and presentation skills, with ability to influence executive stakeholders
Proven history of collaborating with payers, providers, or both on high-priority, high-visibility initiatives
Strong proficiency in data analysis tools for healthcare analytics and experience with reporting platforms such as Tableau.
Knowledge of principles and practices of management and supervision.
Understanding financial documents, budgets and resources allocation practices.
Strong attention to detail and analytical skills, with the ability to accurately capture and interpret diagnostic images.
Effective communication and teamwork skills, with the ability to work collaboratively with healthcare professionals and patients.
Ability to handle potentially stressful situations with professionalism and composure.
Knowledge of federal, state, and local laws, statutes, regulations, codes, and standards related to the area of responsibility.
Knowledge of the principles, concepts, and theories relevant to the assigned functional area.
Skill in completing assignments accurately and with attention to detail.
Ability to communicate clearly and concisely both orally and in writing in English, to various audiences.
Ability to manage time, organize work, set priorities, meet deadlines, and follow up on work assignments with minimal supervision.
Ability to work independently, and as a team, to complete daily activities according to the work schedule.
Working knowledge of Office 365 programs such as Excel, Outlook, Word, PowerPoint, etc.
Supports the Mission, Vision and Values of USHV and the practices.
Bachelor’s degree in healthcare administration, Public Health, Nursing, Business, or related field (or equivalent experience).
Five (5) years' experience in healthcare quality, population health, analytics, or value-based program management.
In-depth knowledge of CMS QPP, MIPS, and quality metrics.
Strong analytical skills with the ability to interpret data and convert insights into recommendations.
Excellent communication, presentation, and stakeholder engagement skills.
Proficiency in Microsoft Excel, Power BI, Tableau, or similar analytics tools.

Nice To Haves

Certifications such as CPC, CPHQ, or CMHP.

Responsibilities

MIPS Program Oversight Analyzes client practices and assesses MIPS eligibility, participation options, and reporting requirements.
Develops and implements MIPS compliance and optimization strategies.
Assists with data collection, measures selection, and performance improvement initiatives.
Reviews and interprets CMS guidelines and changes to MIPS reporting.
Supports clients in preparing and submitting accurate MIPS data.
Monitors and reports on MIPS performance metrics and improvement plans.
Provides regular updates and training to clients and staff on MIPS requirements.
Acts as a subject matter expert on MIPS and related CMS quality programs.
CMMI Model Evaluation & Readiness Evaluates new and emerging CMMI programs (e.g., AHEAD/ASM, etc.).
Assesses organizational readiness and operational impact for participation in new federal pilots and models.
Supports leadership in decision-making regarding participation, performance expectations, and financial implications.
Develops implementation plans for adopted models, including performance monitoring and reporting structures.
VBC Contract Quality Oversight Develops annual performance targets aligned with payer metrics and quality measures
Oversees data collection, validation, and submissions for CMS and commercial programs
Partners with leadership to identify and prioritize high-impact performance initiatives.
Prepares and presents materials for Joint Operations Committees (JOCs).
Develops and administers training related to all VBC quality programs and measures.
Translates data into actionable insights and develops targeted improvement plans with key stakeholders.
Performs other duties as assigned.