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Healthcare Quality Improvement Manager

2 months ago

Atlanta Georgia, United States Northside Hospital Inc. Full time

Position Summary:
Northside Hospital Inc. is a leading healthcare provider, recognized for its commitment to excellence and innovation in patient care.

As we continue to enhance the quality and accessibility of our services, we invite skilled professionals to explore the diverse career opportunities available within our organization.



Key Responsibilities:
Manage comprehensive clinical data evaluation for performance-based reimbursement programs.

Serve as the primary expert on national quality initiatives and regulatory frameworks (including Star Ratings, IQR, OQR, HRRP, VBP, and HACRP).

Formulate and implement strategic goals that align with industry standards and compliance requirements to maximize value-driven healthcare.

Identify and pursue opportunities to minimize expenses while improving the quality of care provided.

Lead initiatives that leverage data analytics to support healthcare reform efforts, focusing on value-based purchasing, readmission rates, and penalty avoidance.

Employ predictive modeling techniques to anticipate performance outcomes related to incentive-based metrics.

Examine risk adjustment strategies utilized by various insurance providers.

Collaborate with data analytics teams to incorporate updates in regulations and methodologies for performance-based and rating programs.

Assess current analytical tools to enhance clinical and operational effectiveness across the institution.

Conduct thorough report evaluations, interpret results, and deliver actionable insights.

Build and maintain collaborative partnerships with healthcare providers and interdisciplinary teams to improve patient care.

Qualifications:

Essential:

  • Bachelor's degree in Nursing, Healthcare Administration, or a related discipline.
  • A minimum of three (3) years of proven experience in managing strategic projects within a complex healthcare environment.
  • At least two (2) years of experience in overseeing performance enhancement initiatives, including the analysis of clinical workflows.

  • Familiarity with relevant national quality standards, patient safety protocols, and regulatory requirements, with the ability to implement these at a local level.
  • In-depth understanding of healthcare system operations.
  • Exceptional communication skills, with a demonstrated ability to convey information effectively in both written and verbal formats.
  • Strong analytical and organizational capabilities.
  • Ability to work autonomously, manage multiple projects concurrently, and adhere to deadlines.
  • Comprehensive knowledge of clinical care processes across various disciplines and expertise in applying clinical technologies to these processes.

Desirable:

  • Master's degree in a Health Services-related field.
  • Certification in CMQ, CPHQ, or other quality improvement methodologies.
  • Proficiency in Microsoft Access, Excel, PowerPoint, Word, and Midas+.
  • Demonstrated maturity, adaptability, and the ability to navigate complex organizational structures with strong critical thinking and problem-solving skills.
  • Solid business acumen and understanding of cross-industry practices, market dynamics, and competitive factors.
  • Ability to identify potential risks and issues that may affect ongoing projects across the organization.
  • Strategic thinking and decision-making capabilities at an organizational level.

Work Schedule:

Standard business hours.