Quality Performance Outcomes Manager

1882

Remote?: 1

Highlights (Bonus, shift, relocation, info for job):

This role would be primarily remote with travel to the assigned region at least quarterly. 

Job Summary

 

The Quality Performance Outcomes Manager is responsible for managing and facilitating the quality improvement outcomes for our centers. These outcomes can include, but are not limited to: NCQA HEDIS®, Pharmacy Quality Alliance (PQA), CMS Stars, CMS Core Set, Risk Adjustment, and State-specific metrics. 

 

This role utilizes metrics to track trends and monitor performance, generate actionable insight, and develop plans to meet goals according to each contracted Payer. The Outcomes Manager works collaboratively with center and cross-functional leadership to create a culture of continuous quality improvement supporting the execution of the Quality Strategy.

 

Duties and Responsibilities

 

• Serve as a liaison to centers to provide continuous monitoring for performance outcomes, providing expert functional and technical knowledge of HEDIS and other performance metrics.
• Develop, recommend, and implement interventions at the center and membership level to improve quality outcomes.
• Create and execute intervention work plans to drive quality improvement.
• Conduct root-cause analysis and develop interventions in response to findings.
• Collaborate with centers to facilitate quality improvement in the clinical care model.
• Review and interpret data and performance reports such as external and internal care gaps, pay for performance, risk adjustment.
• Conduct research in the electronic health record system based on identified member opportunities.
• Regularly present findings to center leadership, collaboratively discussing performance at the member, provider, and payer-level.

 

Minimum Qualifications

 

• Bachelor’s degree in healthcare, business, public health preferred but not required.
• 2 years’ experience in analysis or provider/medical operations experience preferred.
• 2 years’ experience supporting organizational change, performance/process improvement preferred.
• 1+ years’ experience with quality improvement, HEDIS, or Star Ratings.
• Intermediate experience with Microsoft Excel.

 

Working conditions

 

This job operates in a professional office environment.  This role routinely uses general office equipment. 

 

Physical requirements

 

• Ability to communicate clearly and exchange accurate information constantly.
• Ability to remain stationary for long periods of time.
• Constantly operates computer, keyboard, copy and fax machine, phone, and other general office equipment.

 

Direct reports

 

None.

Why Work at AbsoluteCare?

At AbsoluteCare, we serve the most vulnerable individuals in America. These are our neighbors, people who are at higher risk for disease or who have multiple, complex, chronic illnesses. Often, they deal with an unequal healthcare system and wind up seeking basic care from emergency rooms. We take these patients out of those spaces and turn them into members: people who are entitled to some of the best, most focused care this country has to offer. 

We call this “care beyond medicine.” We have turned the doctor’s office into a comprehensive care center. Here, we surround our members with a core care team of doctors, nurses, social workers, and medical assistants who have the time and skills to get to know our members’ needs. We make the most important services available to our members under one roof. This includes a pharmacy, X-rays, a blood lab, nutrition services, urgent care, and much more.

We don’t stop at our four walls. We engage members in the communities where we all live to find the people who need us most. Through these community care teams, we remove the barriers to healthcare that so many people face daily. And it works. 

Our unique care is guided by our core values of accountability, caring, trust, and teamwork. We call it ACT².

AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.

EEO Employer Verbiage: AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.