Current jobs related to Director, Payer Quality Performance - Linthicum Heights - University of Maryland Medical System
-
Linthicum Heights, United States Anne Arundel Workforce Development Corp. Full timeJob DescriptionJob DescriptionDescription:The Data Analyst assists with compiling and analyzing data and producing reports. The Office of Grant Performance and Compliance oversees activities that ensure compliance with policies and regulations as it relates to participants’ eligibility. Also, it analyzes and compiles data for grantors, Local Workforce...
-
Assistant Director
2 months ago
Linthicum Heights, United States The Goddard School of Linthicum, MD Full timeJob DescriptionJob DescriptionBenefits:Bonus based on performanceCompetitive salaryDental insuranceEmployee discountsHealth insurancePaid time offTraining & developmentVision insuranceOpportunity for advancement The Goddard School located in Linthicum is looking for a motivated, self-starter for an Assistant Director position at our School. The ideal...
-
Linthicum Heights, United States MORS Full timeJob Description General Summary Responsible for leading and managing the UMMS population health analytics functions, which includes analyzing clinical and operational data to support population health management initiatives and overseeing the development and implementation of data-driven strategies to improve patient clinical quality outcomes,...
-
Linthicum Heights, United States University of Maryland Medical System Full timeJob DescriptionJob DescriptionCompany DescriptionThe University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical...
-
Accounts Receivable Specialist I
1 week ago
Linthicum Heights, Maryland, United States University of Maryland Medical System Full timePosition OverviewThe University of Maryland Medical System (UMMS) is a distinguished academic private healthcare network dedicated to providing empathetic, high-quality medical services while integrating innovation and research into patient care. Collaborating with the University of Maryland School of Medicine, School of Nursing, and University of Maryland,...
-
Assistant Director
2 months ago
Linthicum Heights, United States The Goddard School of Linthicum, MD Full timeBenefits: Bonus based on performance Competitive salary Dental insurance Employee discounts Health insurance Paid time off Training & development Vision insurance Opportunity for advancement The Goddard School® located in Linthicum is looking for a motivated, self-starter for an Assistant Director position...
-
Director of Benefit Operations
2 months ago
Linthicum Heights, United States Masters, Mates & Pilots Benefit Plans Full timeThe Masters, Mates and Pilots Benefit Plans (“the Plans”) located in Linthicum Heights, Maryland, are currently seeking a Director of Benefit Operations (“Director”), reporting directly to the Administrator. The Director is responsible for overseeing all aspects related to the administration of the Masters, Mates & Pilots Benefit Plans and ensuring...
-
Payor Relations And Contracts Analyst
2 months ago
Linthicum Heights, United States University of Maryland Medical System Full timeJob DescriptionJob DescriptionCompany DescriptionThe University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of...
-
Linthicum Heights, United States University of Maryland Medical System Full timeJob DescriptionJob DescriptionCompany DescriptionThe University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of...
-
Payor Relations And Contracts Analyst
1 month ago
Linthicum Heights, United States University of Maryland Medical System Full timeJob Description ** General Summary** Strong Epic experience is preferred for this position. Under limited supervision to support UMMS enterprise-wide, unregulated, clinical service contracting, develops, analyzes, reports and interprets financial billing and statistics and contracting information. Assists with the formation, implementation and execution of...
-
Financial Analyst
2 hours ago
Linthicum Heights, Maryland, United States University of Maryland Medical System Full timeJob SummaryWe are seeking a highly skilled Financial Analyst to join our team at the University of Maryland Medical System. As a key member of our Payer Relations and Contracting department, you will play a critical role in supporting our enterprise-wide clinical service contracting efforts.Key ResponsibilitiesContract Analysis: Review third-party payor...
-
Linthicum Heights, United States Department of The Air Force Full timeDuties The position serves as the Executive Director, DoD Cyber Crime Center (DC3). DC3 is designated as a federal cyber center by National Security Presidential Directive 54 / Homeland Security Presidential Directive 23, and as a DoD center of excellence for digital/multimedia (D/MM) forensics by DoD Directive 5505.13E. The Secretary of the Air Force is...
-
Accounts Receivable Specialist I
3 days ago
Linthicum Heights, Maryland, United States University of Maryland Medical System Full timePosition OverviewCompany OverviewThe University of Maryland Medical System (UMMS) is a leading academic private healthcare network dedicated to providing high-quality, compassionate care while integrating innovation and research into patient services. Collaborating with the University of Maryland School of Medicine, School of Nursing, and University of...
-
Accounts Receivable Specialist I
3 days ago
Linthicum Heights, Maryland, United States University of Maryland Medical System Full timePosition OverviewCompany OverviewThe University of Maryland Medical System (UMMS) is a distinguished academic private healthcare organization dedicated to providing compassionate, high-quality medical services while integrating innovation and research into patient care. Collaborating with the University of Maryland School of Medicine, School of Nursing, and...
-
Director, Privacy
3 months ago
Linthicum Heights, United States University of Maryland Medical System Full timeJob DescriptionJob DescriptionCompany DescriptionThe University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical...
-
Quality Assurance Lead
2 months ago
Linthicum Heights, United States Sterling Engineering Inc. Full timeJob DescriptionJob DescriptionTitle: Quality Assurance ManagerLocation: Balitmore, MD areaSummary:The Quality Assurance Lead will primarily perform quality reviews for electric and gas commercial and industrial (C&I) designs. This position will be responsible for reviewing designs and applicable programs to ensure they meet standards as part of a tiered...
-
System Supply Chain Logistic Director
1 month ago
Linthicum Heights, United States University of Maryland Medical System Full timeJob DescriptionJob DescriptionCompany DescriptionThe University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of...
-
Director of Operations
3 months ago
Linthicum Heights, United States Island Hospitality Management Full timeJob DescriptionJob DescriptionDescription:As our Director of Operations, you will supervise the Housekeeping and Front Desk Departments. You will be responsible for ensuring the overall success of the front desk, guest satisfaction, and product quality standards are being met or exceeded.This position may require flexible scheduling...
-
Health Equity and Inclusion Strategy Director
10 hours ago
Linthicum Heights, Maryland, United States Maryland Physicians Care Full timeAbout Maryland Physicians CareMaryland Physicians Care is a leading healthcare organization dedicated to providing high-quality services to its members. As a key player in the Maryland healthcare landscape, we are committed to fostering a culture of diversity, equity, and inclusion.Job SummaryWe are seeking a highly skilled and experienced Director of Health...
-
Nurse Manager
5 days ago
Linthicum Heights, Maryland, United States University of Maryland Medical System Full timeJob SummaryProgram OverviewThe Population Health Program Manager is responsible for overseeing the development and implementation of the care management program for the University of Maryland Medical System's Population Health Services Organization. They design workflows to meet program goals and metrics, maintain systems for compliance with accrediting...
Director, Payer Quality Performance
3 months ago
The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you’ll enjoy as a member of our team.
Job DescriptionGeneral Summary
This role will be responsible for the direction, program management and evaluation of quality performance measures. They will guide a team that identifies trends and make recommendations for clinical and operational quality improvement initiatives. Responsible for the management of quality reporting and compliance for multiple payer programs across the enterprise organization. This position supports the design, implementation, and maintenance of a comprehensive provider network/population health quality performance strategies that includes aligning multiple physicians and UMMS systems. This includes organizing and managing teams, developing project plans and schedules, managing issues, risks, costs, managing to schedule and scope and communicating at all levels of the organization. Manage staff during all aspects of the quality measure life cycle. This role should function as a recognized mentor, quality and regulatory role model. Provides clinical outcomes expertise through analysis of population health data (clinical quality measures) extracted from practice EHR, payer data and patient experience data. Serves as a lead in identifying health care trends in health outcomes, utilization, population and disease management, and patient experience. Partners with end users to identify their reporting needs and solutions.
Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
1. Serves as a leader between population health/payer quality programs; prioritizes problems for effective and timely resolution, and develops/communicates resolution plan/approach and recommendations.
2. Provides operational leadership to payer quality and population health programs and staff, while able to seamlessly manage projects as indicated leadership.
3. Responsible for managing assigned teams (internal staff as well as team members in other departments) to ensure project plan objectives remain on target and are achieved in accordance with the action plan deadlines
4. Oversees implementation plan development and coordination of resources to execute the plan In conjunction with clinical and administrative leaders, develops key priorities for advancement of clinical integration relative to program development and clinical quality improvement
5. Supports system-wide governance and committee infrastructure for payer quality programs
6. Works closely and in collaboration with leadership throughout organization, including practice transformation, clinical integration, finance, payer relations, performance improvement, care management, patient experience, marketing and communications, internal and external partners to set the strategic direction for program development, performance improvement and resource deployment
7. Understands UMMS population health vision, goals and strategies and communicates to others. Able to set clear goals and directions.
8. In conjunction with local hospital and practice quality leaders and clinical integration, supports the development of population-based registries, clinical practice guidelines, and evidence-based quality measures aimed at establishing, measuring and monitoring a high standard of clinical excellence for our patients.
9. Regularly communicates progress and impact to key stakeholders and senior leaders through KPIs and other scorecard tools.
10. Determines staffing requirements and directs the work of all direct reports to ensure effective and efficient departmental functions. Serve as resource, primary advisor, and mentor for all direct reports and cascading teams.
A. Hires, orients, trains, conducts performance evaluations, handles disciplinary issues, and provides an open and goal oriented work environment with establish clear and concise work procedures and productivity standards. Conducts performance reviews, and holds employees accountable for optimal performance of their responsibilities.
B. Develops personnel by providing opportunities and training programs to enhance individual employee’s career development.
C. Ensures full staff competency of technologies, regulations, policies and practices across the division.
D. Manages activities of contractors.
11. Implements and enforces departmental policies and procedures.
A. In coordination with departmental management, ensures compliance with regulatory and audit agency requirements.
B. Develops performance improvement initiatives aimed at improving customer service, operating costs, departmental functions/departmental productivity.
C. Develops and executes effective control process and compliance monitoring procedures to ensure risks are measured, monitored, controlled, and mitigated.
D. Represents the department at various meetings, task force groups, quality councils and with other members of the UMMS/QCN.
12. For complex projects or programs, direct the initiative using best-practice program management approaches to deliver against approved estimates for quality on-time and on-budget programs and projects.
13. For programs consisting of multiple subprojects, directs the deployment and organization of resources, including the mentoring of project coordinators and project managers. Ensure development of timetables and targets and check progress against them. Direct the plans of activities; ensures a plan which streamlines the program process.
14. Meet with stakeholders and executive to review solution and issues and to gain commitment on recommendations related to quality payment programs.
15. Exhibits mastery of reporting projects, data manipulation and analysis related to quality payment programs. Provides mentorship.
16. Direct project managers to use the commonalities/differences within the team members’ goals, values and problem-solving styles to generate multiple alternatives in leading group to achieve a result and monitor for effectiveness. Ensure program impact does not negatively impact or interfere with others.
QualificationsEducation and Experience
- Master’s degree in Business, Nursing, Policy, Health Care Administration or a related discipline; or equivalent combination of education certifications and work experience is required. Clinical experience preferred.
- Five (5) years of progressive supervisory/management experience in a healthcare environment is required.
- Experience with various Quality Reporting programs (PQRS, MU, VBM, MIPS) is required. Experience with management and/or engagement with national quality organizations, including National Committee of Quality Assurance (NCQA) structure and standards and Health Plan Employer Data and Information Set (HEDIS) and National Quality Forum (NQF) is required.
- Experience with electronic health record (EHR) data extraction, registry and/or functionality is required.
- Previous experience in leading a project and/or team is required.
Knowledge, Skills and Abilities
1. Demonstrated ability to manage large scale project and/or program teams. Ability to set up, plan, manage, report and communicate medium size projects and direct the completion of projects within proper scope, budget and schedule.
2. Demonstrate ability to think strategically. Demonstrate sufficient understanding of some functions to structure and manage project work. Generate innovative and practical solutions to complex or unusual problems.
3. Support client relationship management and oversees Population Health/Quality project execution and reporting. Possesses excellent customer service skills.
4. Act as lead resource for dealing with project issues, ability to lead projects. Understands appropriate escalation process. Work with the team to make decisions considering the degree of impact on areas involved. Demonstrated ability to reach agreement and potential solutions through flexibility and compromise with peers, customer/client, and managers.
5. Proficiency in the use of personal computers and related peripheral equipment is required. Familiarity with Microsoft Office products and Microsoft Project is preferred.
6. Structure and manage projects to meet/exceed patient, provider and organizational expectations, deliver value and minimize potential obstacles and risks. Understand and manage stakeholder needs and build commitment to project solutions that deliver target business & clinical value.
7. Highly effective verbal and written communication skills are necessary in order to work with all levels within the organization, and produce clear and concise reports of relatively complicated issues.
Working Conditions
- Weekend, shift work, holiday, on-call, and may be require work beyond normal tour of duty to complete projects, meet deadlines, or respond to emergencies.
- Work is performed in various environments within UMMS and practices.
- Work may include regular travel to and from the various affiliated institutions within the Medical System/UMQCN.
- Work may be required in a Healthcare facility which the observance of “Universal Precautions” is mandated. Universal Precautions involves the wearing of protective clothing/equipment and the observance of safe work practice.
- Work is high demand and fast paced.
- Talking and hearing necessary for conversations with callers, visitors, patients, families and staff members.
Additional Information
All your information will be kept confidential according to EEO guidelines.
