Quality Improvement Manager

5 months ago

Bronx, United States Essen Medical Associates Full time

Overview:

At Essen Health Care our tagline is Where Care Comes Together.

As the largest privately held multispecialty medical group in the Bronx, we provide high-quality, compassionate, and accessible medical care to some of the most vulnerable and under-served residents of New York State. Guided by a Population Health model of care, Essen has five integrated clinical divisions offering urgent care, primary care, and specialty services, as well as nursing home staffing and care management. Founded in 1999, our over 20-year commitment has fueled an unwavering dedication toward innovating a better healthcare delivery system. Essen has expanded from a single primary care office to an umbrella organization offering specialties from womens health to endocrinology, from psychiatry to a vast array of other specialties. All clinical services are offered via telehealth or in-person at over 35 medical offices and at home through the Essen House Calls program.

Essen Health Care is the place Where Care Comes Together We are looking for the most talented and effective individuals to join our rapidly growing company. With over 1,100 employees and 400+ Practitioners, we care for over 250,000 patients (about half the population of Wyoming) annually in New York City and beyond. From medical providers to administration & operational staff, there is a career here for you. Join our team today

Job Summary:

Under the Director of Quality, manages and leads the primary aspects of quality program for the Health Home Division, inclusive of monitoring key health outcomes, establishing performance improvement projects, and resolution of gaps-in-care. The incumbent will provide direct management and supervision to quality specialists in their role of conducting chart reviews, audits, monitoring trends and maintaining the quality of the Health home program.

Responsibilities:
  1. Provide individual and group supervision to quality specialists.
  2. Oversee quarterly audits, results and implement actions to address any identified improvement opportunities.
  3. Lead monthly QI meetings to ensure compliance and adherence to all metrics, policies and protocols.
  4. Manage implementation and execution of corrective action plans in response to program evaluation reports
  5. Identify trends from standardized chart review tool(s) to enhance compliance of care coordination activities with all federal, state, local, and agency regulations.
  6. Supervise chart audit practices through development and maintenance of appropriate guidance/policy documentation of these processes.
  7. Synthesize data that aggregates quality projects outcomes (chart reviews, incident reports, gaps-in-care, quality scorecards, HEDIS measures, etc.) for the Health Home membership.
  8. Supports implementation and update of Federal, State, local, and payer policy/guidelines, inclusive of Health Home policies changes/updates.
  9. Develop written action plans using Plan, Do, Study Act model to improve any deficits in documentation/records.
  10. Monitors execution of appropriate QI activities (e.g. staff training, coaching) to support quality oversight and ensure that corrective action plans are completed by target dates.
  11. Monitors quality metric benchmarks such as HEDIS measures, triple aim initiatives (reduce hospital and ER/ED visits; increase primary care connections)
  12. Oversee reportable incident protocol and review compliance with all incidents reports in accordance with lead health home and and/or New York State Department of Health policies and recommendations.
  13. Support development and delivery of training/education to improve QA/QI outcomes.
  14. Attend system-wide quality initiative meetings, and all other out of system quality initiatives/conferences to represent Health Home program.
  15. Correspond with Lead Health Home quality requests and audits.


Qualifications:
    • Master's degree in social work, psychology, mental health counseling or healthcare related fields (i.e., MPH, etc.).
    • Minimum 2 years of supervisory experience.
    • Experience with quality and compliance, audits, Health Home, Medicaid and DOH regulations.
    • Experience with population health and integrated care models.
    • Experience with electronic health records (EHRs), Medicaid billing, ePACES, Medicaid Analytical Patient Portal (MAPP), Universal Assessment System (UAS)
    • Proficient with Microsoft excel, including advanced skills with high level reports.
    • Have a basic understanding of Care Management.
    • Experience with presenting data and data visualizations (i.e., Microsoft excel, Tableau, etc.)

    Job Requirements:

    • Demonstrates ability to learn new things in stated time-frame
    • Motivational in a positive team environment
    • Strong organizational and interpersonal skills
    • Excellent time management skills and ability to multi-task
    • Familiarity with Electronic Medical Records (E-Clinical Works, FCM Preferred).
    • Bilingual Spanish preferred


Equal Opportunity Employer:

Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.

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