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PACE Quality Program Manager
2 months ago
Job Description Summary:
Responsible for the successful coordination and management of the Program of All-Inclusive Care for the Elderly (PACE) quality improvement program. This position works closely with the PACE Executive Director, Medical Director, and Center Manager to ensure regulatory requirements are met and that quality-of-care concerns are addressed.
Essential Responsibilities:
- Develop, implement, and routinely evaluates PACE Quality Improvement plan, including QI activities and quality reporting.
- Track and analyze organizational data to identify opportunities for improvement, set measurable targets, and monitor effectiveness of change.
- In collaboration with PACE Medical Director and Executive Director, develop and implement annual QAPI plan, including submission of the plan for review annually by the PACE governing body.
- Coordinates the review of input from the PacificSource PACE Quality Committee.
- Ensure program requirements are met and reports findings to PACE Governing Body.
- Oversee quality reporting requirements for accuracy and timeliness of submissions to State APD and CMS.
- Collaborate with leadership in planning and organization of processes associated with the QI program.
- Represent PacificSource PACE with government agencies regarding quality and participating actively in regulatory audits.
- Utilize QI models to measure and improve performance, including, utilization of services, satisfaction and effectiveness surveys, , and assessments .
- In collaboration with PACE Leadership and Compliance, ensure compliance with all applicable regulatory standards.
- Collaborate with cross functional teams to support critical program activities and achieve performance targets.
- Coordinate responses with Grievances and Appeals. Report out on trend to the PACE Governing Body, State APD and CMS.
- Monitor CMS Complaint Tracking Module (CTM) and coordinates timely response to complaints, including corrective action planning.
- Stay apprised of current quality improvement trends in PACE through engagement with the National PACE Association Quality Committee. Implement relevant measures at PacificSource PACE.
- Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
Supporting Responsibilities:
- Meet department and company performance and attendance expectations.
- Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
- Participate in and support project teams led by other departments and provide necessary input to support the goals of colleagues.
- Perform other duties as assigned.
SUCCESS PROFILE
Work Experience: Three years of experience focused on quality improvement and application of state/federal regulations required. Three years of experience working in health care setting required. Experience working in geriatric community-based care preferred.
Education, Certificates, Licenses: Bachelor’s degree in health-related field required. Master’s degree in health-related field, or clinical licensure as an RN, OT, MSW, preferred.
Knowledge: Knowledge of PACE requirements, including care delivery model and regulatory requirements. Must have strong analytical and problem-solving skills. Ability to lead with high motivation and strong interpersonal/communication skills (oral and written) to accurately and effectively interpret data and communicate results to internal and external customers. Knowledge and experience using PDCA cycles and other QI models to initiate change. Knowledge and use of data management platforms, including the ability to generate reports and analyze data.
Competencies
Building Trust
Building a Successful Team
Aligning Performance for Success
Building Partnerships
Customer Focus
Continuous Improvement
Decision Making
Facilitating Change
Leveraging Diversity
Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 10% of the time.