Performance Improvement Specialist

Employment Type
Full time

Shift
Day Shift

Description
SUMMARY:
The Performance Improvement Specialist serves as a key member of the Saint Alphonsus Health Alliance (Alliance) Quality and Performance Improvement team. This position works collaboratively with internal (i.e. Alliance) and aligned (Saint Alphonsus Medical Group [SAMG], Saint Alphonsus Health System [SAHS], independent practices, and payers) stakeholders to: assess the network and its participant's achievement of the Triple Aim (i.e. reduce cost, improve quality, and optimize patient experience), identify performance improvement opportunities, and support performance improvement initiatives. Through collaboration and clinical integration, this position will play a key role in empowering providers to maximize the value of care provided to the patients that the Alliance and its participants serve.

Experience Required

• Must possess knowledge normally acquired through the completion of a bachelor's degree in business or healthcare related field, with two (2) or more years of related experience, or equivalent combination of education and experience.
• Experience working in a health system, hospital, medical practice or payer organization required.
• Physician practice management experience preferred. Working knowledge of health care business practices, physician practice workflow, provider billing, risk coding and payer contracting preferred gained through experience.
• Experience working in a quality and/or performance/process improvement role preferred.
• Knowledge of NCQA and HEDIS standards and Medicare Advantage Star ratings gained through experience strongly desired.
• Experience analyzing and identifying performance improvement opportunities using quality, cost and utilization data preferred.
• Experience working with down-side risk contracts preferred.
• Proven ability to complete large, complex projects in an accurate, timely and autonomous fashion required. Strong analytic skills required. Excellent verbal and written communication skills including a proven ability to make clear, concise presentations that inspire and motivate others required.
• An understanding of the fundamentals of patient-centered health care preferred.
• Working knowledge of six sigma and LEAN preferred.

Essential Functions

• The Performance Improvement Specialist will function as a consultant in the field, supporting, educating providers within the SAHA network Educate providers, practice managers and other members of the healthcare team on performance measures (e.g. quality, utilization, cost, care coordination, etc.), performance improvement initiatives and performance improvement methodologies. Ensure Population Health Management tools are functioning and communicate issues to team members as necessary.
• Prepare and distribute educational materials such as process improvement methodologies such as PDSA methodologies for providers and clinic staff.
• Support and perform as necessary outreach to current members (e.g. facilitating establishment with a primary care provider, supporting scheduling appointments for care gap closure, etc.). Prepare and distribute patient rosters to practices on a monthly basis. Support data collection, input, and reporting for all performance improvement programs.
• Identifying internal opportunities —whether staffing, systems, or workflows—and initiating targeted interventions using the PDSA model.
• Accurate documentation about recommended improvements will be documented in the MPRI software to track progress.
• Prepare and analyze monthly/quarterly practice gaps in care and performance reports. Serve as a liaison for practice inquiries (e.g. attribution, gap closure, quality scores, etc.).
• Prepare and analyze performance dashboard for Alliance Board and Committee meetings.
• Validate the accuracy of Alliance and payer performance reports and communicate discrepancies to Alliance team members as necessary. Initiate and execute operational assessments for participating practices. Develop, document, execute, track and communicate progress in relation to practice based performance improvement plans/initiatives. Collaborate with practices to optimize documentation, data capture performance improvement initiative related workflows.
• Collaborate with payer partners to: assess practice and network performance; identify opportunities for improvement; and coordinate improvement and outreach initiatives. Establish, influence, and manage internal and external cross-functional relationships to ensure the effective execution of Alliance initiatives. Meet and adhere to established confidentiality, productivity and quality standards.
• Collaborative and comfortable operating in a shared leadership environment. Demonstrate ability to function effectively in a dynamic, fast-paced environment. Demonstrate customer focused interpersonal skills to interact in an effective manner with patients and families, practitioners, the interdisciplinary health care team, community agencies, payers, with diverse opinions, values, religious and cultural beliefs. Demonstrate ability to work autonomously and be accountable for outcomes. Other duties as assigned.

Colleagues of Saint Alphonsus Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout SAHS and Trinity Health.

Visit to learn more about the benefits, culture and career development opportunities available to you at Saint Alphonsus Health System.

Saint Alphonsus and Trinity Health are committed to promoting diversity in its workforce and to providing an inclusive work environment where everyone is treated with fairness, dignity and respect. We are committed to recruit and retain a diverse staff reflective of the communities we serve. Saint Alphonsus and Trinity Health are equal opportunity employers and prohibit discrimination against any individual with regard to race, color, religion, gender, marital status, national origin, age, disability, sexual orientation, or any other characteristic protected by law.

Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.