Quality Improvement & Population Health Supervisor
Reporting to Director of Quality Measurement & Improvement, this position is responsible for:
• Leadership, mentorship, and supervision of the Quality Improvement & Population Health functions performed by the QI Specialists and Health Promotion Educator.
• Year-round coordination of CenCal Health’s population health quality improvement processes. Includes, but is not limited to design, implementation and maintenance of:
o Innovative quality improvement interventions to maximize the plan-wide quality of identified clinical priorities;
o CenCal Health’s Gaps in Care and P4P programs, including ongoing strategic program design to motivate change in practitioners’ patterns of practice to achieve CenCal Health’s population health objectives.
o Programs to improve clinical quality of the select conditions encompassed by CenCal Health’s SMART population health management programs.
• Plan-wide coordination and development of Process Improvement Projects (PIPs) required to document CenCal Health’s resource commitment and activities to improve select aspects of care, including the submission of PIPs to applicable regulators.
• Annual update, maintenance, and development of CenCal Health’s Quality Program Description, Quality Program Annual Evaluation, and associated work plan documents, including but not limited to the coordination of plan-wide updates by staff, and presentation to oversight bodies up to and including the QIC.
• Serve on various staff committees and lead teams and workgroups as appropriate.
• Ability to inspire and lead quality improvement and health promotion staff, and establish and maintain positive professional working relationships, both within and outside CenCal Health
• Ability to motivate superior performance and the professional development of subordinate staff; knowledge or principles and techniques of effective management, including training and evaluation
• Extensive knowledge of quality improvement theory, strategy, and practical methods to achieve rapid-cycle improvement
• Extensive experience performing quality improvement in a direct-contract, managed care environment
• Ability to perform effectively under pressure and maintain focus on daily responsibilities for long-term projects
• Ability to creatively approach operational systems development and improvement, and function independently while managing multiple priorities
• Ability to establish and nurture positive professional working relationships with CenCal Health customers
• Proven ability to succeed independently in a fast-paced environment while managing multiple priorities
• Ability to evaluate data, establish facts and draw valid conclusions
• Effective oral and written communication skills
• Proficiency in Microsoft Word and Excel
• Ability to perform HEDIS medical record abstraction in circumstances when collaboration with the Quality Measurement team will relieve Department workload and achieve CenCal Health’s strategic objectives
• Bachelor’s Degree in a job-related field
• Two (2) years experience leading managed care quality improvement in a managed care or medical setting
• Two (2) years of State or Federal regulator audit participation or management is required
• Two (2) years supervisory experience, or any combination of education and experience to assure the required knowledge, skills and abilities to effectively supervise in a fast-paced environment
• A graduate degree in a healthcare- or management-related discipline (e.g., MBA, MPH)
• Certified Professional in Healthcare Quality (CPHQ) or similar certification
• HEDIS medical record data abstraction
• An emphasis in Medicare or Medicaid/Medi-Cal managed care