Vista PACE Quality Analyst I

San Ysidro Health•Vista, CA

17d•$33 - $43

About The Position

The Quality Analyst I supports the San Diego PACE Quality Assurance and Performance Improvement (QAPI) Department under the supervision of the Quality Supervisor for IDT. The role collects, documents, tracks, and monitors data in accordance with applicable federal and state regulations, accrediting requirements, and San Diego PACE policies and procedures. In coordination with QAPI and operational leadership, the analyst assists with investigating and resolving incidents, grievances, appeals, and potential quality-of-care concerns. The analyst contributes to annual QAPI Work Plan reviews; development, implementation, and monitoring of program-wide and center-specific performance measures; data management; staff education and training; reporting; and improvement efforts arising from monitoring or audits. The position also provides support to the Interdisciplinary Team (IDT), including documenting and following up on care planning, meetings, transitions, grievances, and participant service concerns. The position requires strong written and verbal communication, organization, attention to detail, customer service, integrity, and objective problem-solving. It involves work in a general office environment, prolonged sitting with occasional standing and walking, possible evening or weekend work, and some travel for meetings and training. Tuberculosis clearance and current First Aid and CPR certification are required.

Requirements

Associate’s degree or higher in a health-related field; 1–3 years of relevant work experience may substitute for education, and a combination of education and work experience may be considered.
For Quality Analyst I, 1–3 years of experience in healthcare quality or compliance, preferably in Quality Improvement or Compliance, and familiarity with quality improvement processes. Experience as a PACE IDT member can meet the minimum quality and compliance requirements.
Excellent written and verbal communication skills and the ability to maintain accurate records.
Active listening skills and knowledge of adult learning modes to train, facilitate, and motivate staff in quality improvement activities.
Proficiency in Microsoft Office Suite, including Word, PowerPoint, Excel, Outlook, and Visio, to present data in understandable formats.
Advanced computer skills and ability to learn specialized applications.
Ability to meet standardized competencies for the position established by San Diego PACE and approved by CMS.
Tuberculosis clearance and current First Aid and CPR certification.
Pre-employment requirements include an I-9, physical examination, positive background and reference check results, completed application, new-hire orientation, and pre-employment TB clearance.

Nice To Haves

Bachelor’s degree in a related field.
For Quality Analyst I, 1–3 years of demonstrated analytical experience involving data collection, organization, and reporting.
Certified Professional in Healthcare Quality (CPHQ) certification.
Certified in Healthcare Compliance (CHC) or Certified in Healthcare Privacy Compliance (CHPC) certification.

Responsibilities

Collect and track real-time data and provide feedback and guidance to the IDT by participating in IDT meetings and ensuring QAPI elements are documented appropriately.
Help the IDT and Center Manager recognize and document performance elements at risk of noncompliance.
Gather data from various sources and organize it for analysis and interpretation.
Collect, track, and monitor Level I reporting data and enter it quarterly into the Health Plan Management System (HPMS).
Analyze SD PACE QAPI data, recommend improvements, and help develop and lead QAPI projects using Plan-Do-Study-Act (PDSA) processes.
Collaborate with departments and stakeholders to address potential QAPI issues.
Prepare data for QAPI presentations and organize large datasets using appropriate software.
Assist with reports to state and federal regulators and prepare electronic files and documents for CMS quarterly calls and CMS or state audits.
Prepare meeting materials, reports, and presentations as assigned.
Review electronic health records for data collection, investigations, and medical-record documentation quality checks.
Assist with drafting and mailing notices of action, grievance, and appeal letters.
Maintain knowledge of policies and procedures and perform work in accordance with applicable regulations, laws, and accreditation standards.
Monitor and track participant grievances, complaints, and dissatisfaction with the IDT Moderator to identify trends, and assist leadership with service recovery.
Support participant care, new participant activities and orientation, and coordination of IDT meetings, care planning, interdisciplinary conferences, daily meetings, family conferences, and follow-up.
Perform routine care plan audits and follow up with disciplines on care plan interventions and evaluations.
Support continued IDT development and decision-making by troubleshooting, advising, teaching, coordinating, and delivering care and services.
Serve as a liaison among program disciplines and community service providers.
Ensure hospital and Skilled Nursing Facility transitions are coordinated and implemented in accordance with the SD PACE standard of care.
Promote IDT engagement and ensure team decisions are documented.
Communicate with staff, caregivers, participants, and the community; attend required meetings and committees; support a culture of compliance, ethics, and integrity; and participate in professional development.
Perform other duties as assigned.