Supervisor - Quality Care Improvement

Supervisor - Quality Care Improvement

Department: Quality - Risk Adjustment

Employment Type: Full Time

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

Reporting To: Yuvone Washington-Oshon

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

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

• 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 Coordinators 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,…