Quality Manager

Heart of Ohio Family Health-posted 4 months ago
Full-time • Mid Level
Columbus, OH
101-250 employees
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The primary function of the Quality Program Manager is responsible for providing day to day management of the quality improvement program. Responsible for coordinating activities of quality department staff, suggesting process changes, measuring data, and completing QA activities to achieve organization goals for quality measures for programs like UDS, Accountable Care/Clinically Integrated Networks, Ohio Medicaid CPC, CPC Kids, CMC, and individual insurance plan contracts.

  • Work with supervisor and members of clinical leadership to develop, implement, monitor, and measure plans to improve processes and quality outcomes.
  • Work with supervisor, clinical leadership, data analytics team, and external data vendor Unity PHM to analyze data, clean data, and perform quality assurance activities.
  • In collaboration with supervisor, Chief Medical Officer, and others, the position is responsible for carrying out system-wide quality programs. Assists with developing, planning, and implementing policies and procedures.
  • Works closely with supervisors, clinical teams, and non-clinical teams for quality improvement efforts. Assists with designing processes for quality improvement purposes.
  • Plays a key role in maximizing revenue from value-based care, pay-for-performance, and risk adjustment contracts. Ensure compliances with program requirements.
  • Focuses on better healthcare value and quality, including the improvement of clinical outcomes, patient experience, patient safety, costs, revenue, productivity, efficiency, employee and physician satisfaction, and process reliability.
  • Leads or participates in meetings related to quality improvement.
  • Coordinate, manage and report UDS measures and other data related to clinical quality.
  • Manages performance improvement projects to assure milestones and key performance indicators are met within defined parameters.
  • Develop and motivate department staff. Interview, monitor time and attendance, and manage performance of subordinates.
  • Report on clinical quality measures internally and externally. Provide updates to internal and external stakeholders on progress in quality initiatives.
  • Support data collection and reporting related to grants.
  • Bachelor's degree in a related field required. Examples include nursing, healthcare administration, public health, or similar.
  • At least four years of experience in the healthcare field, quality, data analytics, and/or management strongly preferred.
  • Knowledge of clinical operations including the functions of the front and back-office utilization information systems is preferred.
  • Previous experience working in an outpatient clinic is preferred.
  • Excellent communication skills, both written and verbal, are required.
  • Strong organization and time management skills are required.
  • Ability to work independently and demonstrate initiative is required.
  • Proficiency with Microsoft Office is required.
  • Certifications such as CPHQ and Lean Six Sigma are beneficial, but not required.
  • Displays cheerful demeanor and makes positive comments when on duty.
  • Works cooperatively with other staff members.
  • Displays sensitivity in a multi-cultural environment.
  • General understanding of the medical billing process is preferred.
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