Primary Care Capitation Quality Metrics Lead

State of North Carolina•Wake County Wake, NC

1d•$63,927 - $111,871•Hybrid

About The Position

The Primary Care Capitation Quality Metrics Lead is an operational quality leader and subject matter expert who guides the design and refinement of quality measures that advance the goals of the Medicaid Rural Health Primary Care Capitation Pilot. The role spans HEDIS, value-based payment metrics, and operational/access guardrails needed for capitation in rural primary care. The role will partner with DHHS’s Data Office and external vendors, without duplicating their analytic functions, to ensure measures and monitoring approaches are credible and practical. The Lead also supports provider facing technical assistance by advising ROOTS Hubs and vendors on training content, change management, and measure adoption.

Requirements

Master's degree in public or human service administration or human services programmatic field from an appropriately accredited institution, and three years of human service experience, two of which must have been in human services program planning OR Bachelor's degree from an appropriately accredited institution, and five years progressive administrative or consultative experience in a human service program, two of which must have been in human service program planning OR An equivalent combination of education and experience
Master's degree in the field of psychology, sociology, or social work from an appropriately accredited institution, and three years of experience in research and evaluation, using statistical methodologies in human service programs OR Bachelor's degree from an appropriately accredited institution, and five years of experience in research, evaluation and statistical application in the human service field OR An equivalent combination of experience

Nice To Haves

Highly proficient with common tools used for quality measurement (Tableau, Cognos, CareAnalyzer, Flexible Analytics, Quality Compass) and experienced with statistical software such as Stata, SAS, or R.
Extensive knowledge of national and standard health and quality‑of‑care measures (NCQA HEDIS Measures, CMS Medicaid and CHIP Adult and Child Core Measures, AHRQ Indicators, and others).
Demonstrated ability to interpret complex data, datasets, and other information to identify and communicate trends and probable outcomes, supported by excellent critical‑thinking, problem‑solving, and project‑management skills.
Demonstrated skill in creating and maintaining collaborative working relationships with internal and external stakeholders, with flexibility to adapt to shifting priorities and short‑term deadlines.
Demonstrated ability to communicate complex material in a clear and concise manner, both verbally and in writing.

Responsibilities

Guides the design and refinement of quality measures that advance the goals of the Medicaid Rural Health Primary Care Capitation Pilot.
Spans HEDIS, value-based payment metrics, and operational/access guardrails needed for capitation in rural primary care.
Partners with DHHS’s Data Office and external vendors to ensure measures and monitoring approaches are credible and practical.
Supports provider facing technical assistance by advising ROOTS Hubs and vendors on training content, change management, and measure adoption.