Regional Quality Lead

P3 Health Partners•Tucson, AZ

2d•Hybrid

About The Position

The Regional Quality Lead oversees and leads the Regional Quality Coordinator team. This role is responsible for developing and implementing strategic initiatives to improve HEDIS and quality outcomes across P3 Health Partners' affiliate groups. The position requires leadership skills, knowledge of Medicare Quality Stars metrics, and the ability to drive operational excellence in support of P3's mission to guide communities to better health.

Requirements

HS Diploma required

Nice To Haves

Medical Assistant certification preferred

Responsibilities

Lead and mentor a team of Quality Operations Coordinators, providing guidance, support, and performance management.
Develop and implement strategic plans to improve HEDIS scores, CMS Star Ratings, and other quality metrics across P3 Health Partners' network.
Collaborate with market VPs and the National Quality Manager to align quality initiatives with organizational goals and objectives.
Collaborate on execution of quality improvement projects, including Quality Fairs, Diabetic Days, and other P3 events.
Provides telephonic outreach to patients, providers, and pharmacies to discuss opportunities for optimizing medication use or other opportunities for improvement of healthcare performance measure related issues.
Participates in data collecting through medical records and claims surveillance.
Prepares Quality information for presentation to affiliate groups, including groups current standings relative to others and opportunities or improvement.
Serve as the primary liaison between the Quality Operations team and other departments, ensuring effective cross-functional collaboration.
Manage relationships with providers and other external stakeholders to drive quality improvements and ensure compliance with quality standards.
Develop and maintain standard operating procedures for quality operations, ensuring consistency and efficiency across the team.
Lead regular team meetings and participate in Quality Management meetings to review progress, address challenges, and share best practices.
Stay current with industry trends, regulatory requirements, and best practices in healthcare quality management.
Provide regular reports and presentations to National Quality leadership on quality performance.
Ensure compliance with HIPAA, CMS, NCQA, and other relevant regulatory requirements.
Continuously evaluate and optimize the use of technology and data analytics to improve quality outcomes.
Other duties as assigned by senior leadership.