Supervisor - Quality Care Improvement

Department: Quality - Risk Adjustment

Location: 600 City Parkway West 10th Floor, Orange, CA 92868

Compensation: $85,000 - $105,000 / year

Description

As Supervisor of Quality, you will be responsible for supervising the deliverable action plans with the goal of improving Risk Adjustment Factor (RAF), Hierarchical Condition Categories (HCC), Total Cost of Care (TCOC), Quality, and STARS Measures, leading to better overall patient care and health outcomes by supporting the medical group's physicians and practices and maintaining the highest level of quality improvement performance status across all lines of business.

Our Values:

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team
  
  

What You'll Do

• Act as an SOQ for initiatives from basic to moderate in the scope of quality improvements and applies knowledge of quality concepts to standardize workflows.
• Work on problems of diverse scope where analysis of quality attributes & metrics requires evaluation of identifiable areas of improvement factors.
• Reporting to the Medical Director, the ultimate responsible party for Quality from identification, improvement, initiation, implementation to closure.
• Must have demonstrated experience in situations where the development of the solution requires a multi-level of training approach.
• Actively contributes to the team and inter-departments with guidance from the Medical Director to assign provider quality improvement projects from the supervising kickoff to the post- implementation phase.
• Introduce and train quality improvement methods/procedures to the Quality Improvement Coordinator (s) and any direct reports to provider practices.
• Applies and advises advanced quality improvement processes, protocol, workflow & principles to provider practices.Ensures that quality improvement and operational requirements are defined for practices, implemented, and monitored in adherence to the Medical Group and Health Plan's quality requirements.
• Able to identify and assess quality improvement opportunities for/from provider practices.
• Promotes the awareness of quality, regulatory, health plan, and medical group requirements.
• Ensures quality standards are met under the guidance of the Medical Director.
• Publishes reports and documents areas of improvement and recommends potential solutions when appropriate to promote quality.
• Strong writing and communication skills; ability to communicate effectively both to external stakeholders, providers, and office staff, as well as internal stakeholders & colleagues.
• Collaborates and communicates with the Operations team to escalate issues and resolve practices, quality improvement & performance opportunities.
• This individual must be flexible in supporting internal & external stakeholders during extended hours.
• Promotes the Medical Group mission, goals, and strategic plan with the goal to improve Quality.
• Supervises, onboards, orients, and adhere the train-the-trainer methodology of Quality Improvement
• Coordinator(s) and new direct reports to ensure understanding of duties, responsibilities, work requirements, plans, tactics, culture, skills and performance standards.
• Reporting relationships and staffing needs based on Quality goals.
• Stays abreast of changes that impact quality measures including, but not limited to: Centers for Medicare Services (CMS), HEDIS, RAF, HCC, TCOC, Quality, and Stars Measures.
• Supervises the direct reports to better overall patient care and health outcomes by supporting the medical group's physicians and practices and maintaining the highest level of quality improvement performance status across all lines of business.
• Creates reports to track performance metrics and clinical outcomes that relate to the performance of the project.
• Applies provider practices analytic skills to evaluate, summarize, present, and recommend action based on quality improvement methodologies.
• Identifies opportunities for implementing innovation and novel approaches to provider practices and technical gaps in care delivery by utilizing the train-the-trainer institution practices and evidence-based performance reports and platforms.
• Facilitates additional quality improvement projects as needed and assigned by the Medical Director.
• Ensuring timeliness, milestones and smooth workflow.
• Administering all processes and procedures and ensuring compliance with all quality goals.
• Preparing reports for all project statistics on a monthly basis and analyzing all project metric data with the Medical Director, providers and peers.
• Developing, reviewing, and maintaining project plans for the successful implementation and completion of projects.
• Supervises the implementation methods to inspect, test and evaluate products and production equipment.
• Ensuring that products adhere to quality standards based on the Medical Director's guidance.
• Preparing reports by collecting, analyzing and summarizing data.
• Working according to deadlines for the delivery of products and reaching project goals.
• Understands strategic quality initiatives and performance programs and aligns improvement work with the strategic goals of the quality department and the organization.
• Facilitate conducting quality committee and meeting minutes.
• Updates policies and procedures as needed when changes or requirements occurs under the approval of the Medical Director.
• Commits to support functional areas to keep the quality goals successfully operating.
• Other duties as assigned by the CEO and leadership.
  
  

Qualifications

• CCS/CPC certification (AAPC or AHIMA)
• Experience in a people management role
• Associate's degree and equivalent years of healthcare or medical group related work experience; or equivalent combination of education and related work experience.
• 2-5 years of quality, care coordination or Medical Assistant experience.
• Strong working knowledge of care and quality improvement.
• Strong knowledge of Microsoft Office
• Knowledge in provider training and coding education.
• Effective written and verbal communication.

You're great for the role if:

• CRC or RHIT certification
• Bilingual in Spanish, Chinese (Cantonese/Mandarin), Vietnamese, or Tagalog
  
  

Environmental Job Requirements and Working Conditions

• Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The home office of this department is located at 600 City Parkway West, 10th Floor, Orange, CA 92868.
• The total compensation target pay range for this role is $85,000 - $105,000 per year. The salary range represents our national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.

Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.