Practice/performance Improvement Associate

2 weeks ago


Worcester, United States UMass Memorial Health Care Full time

Exemption Status:
Exempt

Schedule Details:
Monday through Friday

Scheduled Hours:
8:00am-5:00pm

Shift:
1 - Day Shift, 8 Hours (United States of America)

Hours:
40

Cost Center:
99940 - 5824 Performance Improvement

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 16,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

Collaborates with the Manager / Practice Improvement Facilitator (PIF) to implement Population Health Management and workflow redesign to improve performance measures for all providers in the Managed Care Network and in accountable care relationships with UMass Memorial Health (UMMH).

Supports ongoing education, consultation, and monitoring of practice, post-acute, or community-based providers and clinical staff, as each identifies and implements clinical and operational changes to achieve the optimal quality and efficiency improvements necessary for delivery of health-oriented, patient-centered, value-based care.

Partners with the Manager / PIF to assist practice, post-acute, or community-based providers and clinical staff with workflow redesign to optimize patient access, chronic and preventive care, electronic medical record use, patient-centeredness, cultural competence, and team-building.

Major Responsibilities:

- Works closely with Manager / PIF and providers to support organizing teams, defining roles and responsibilities, and developing standards of work to improve performance in quality and efficiency of care delivery. Works with provider staff to redesign workflows and processes to better serve patients.
- Train’s providers and staff to understand and use data effectively to drive Quality Improvement (QI).
- Helps provider teams organize, prioritize, and sequence QI activities, define actionable goals and plan small-scale tests of change.
- Assists provider teams in increasing capacity for continuous QI activities and supports the maintenance of ongoing QI infrastructure.
- Helps assigned provider teams to understand characteristics of efficient, high performing organizations and establish an action plan for (any necessary adaptation and) adoption of best practices.
- Facilitates provider teams in transition from transaction to value-based model of care that is patient-centered and population health-based.
- Assists in identifying barriers to adoption of patient-centered standards of work and works with provider teams to understand and implement changes to achieve attributes of patient-centered medical home or other value-based models and related initiatives.
- Document’s performance improvement work in keeping with established protocols. Supports department business planning and performance analysis.
- Responsible for auditing, monitoring, and driving quality improvement initiatives across providers. Monitors Federal and State regulatory guidelines, patient experience data, and quality measures to develop timely and relevant provider-specific performance packets for quarterly utilization reviews and ongoing partner performance compliance with value-based program care protocols and care management expectations (e.g., ACO, Bundle Payment Care Improvement (BPCI-A)).

Additional Major Responsibilities:

- Responsible for assessing quality of patient outcomes by reviewing patient case studies with post-acute partners (IRFs, SNFs, HHAs, Hospices) and internal care management and making recommendations on additional care transition interventions, changes in preferred network partner line-up.
- Assesses facility and agency alignment with preferred criteria and makes recommendations for corrective action plans when a preferred post-acute partner no longer qualifies due to deficiencies, poor performance results or lack of invested and active participation in supporting value-based program collaboration.
- Works with skilled nursing facilities on length of stay and readmission reduction strategies
- Supports UMMH Care Coordination teams in overall system-wide post-acute network strategy. Develops and supports long term care (LTC) strategy for UMMH acute patients transitioning to Mass Health / Medicaid. Support Skilled Nursing Facility (SNF), Home Health Agency (HHA) and Hospice assessments for a systemwide use of these preferred networks.

Position Qualifications:
License/Certification/Education:
Required:

- Bachelor’s degree in Healthcare, Business Administration, Social Work or related field.

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