Manager - Atrium Health Quality Improvement & Regulatory Operations Medical Group Charlotte FT

Job Summary

Manages the operations of the ambulatory quality department and is accountable for achieving leadership targets within determined scope of responsibility for quality, team member engagement, financial and operational performance. Manages and develops a team of Quality Improvement professionals to ensure quality and cost metrics are met for prioritized internal and external partners including those required or rewarded by government and payer relationships. Leads and supports the implementation of quality improvement initiatives for AAH primary care practices/clinics. Applies project management, quality, and safety improvement frameworks, methodologies, and tools, evidence-based and/or best practice, and statistical theory and tools for data analysis. Upholds all AH Leadership Behaviors while performing responsibilities. Collaborates with key Atrium Health stakeholders to optimize the quality of care provided to our patients. This position is responsible for overseeing project management of clinical outcomes improvement within Atrium Health and directing a team to help achieve goals. This position participates in strategic planning and deploys and supports system level resources to achieve system quality goals. 

Essential Functions
 

• Oversees clinical reporting product and teams associated with same and proactively works with internal and external teams to report and refine reporting of quality measure performance.
• Maintains and assesses on-going system trending to identify priorities and opportunities for improvement in relation to the overall Atrium Health strategic plan; continuously generates ideas for improvement.
• Develops and maintains cooperative internal working relationship with all parts of the Total Enterprise to effectively evaluate, assess, and drive meaningful improvement of quality metrics.
• Maintains current working knowledge of all Atrium Health value agreements, drives improvement, and performs assessments on quality measures within these agreements.
• Stays abreast of industry changes in value-based reimbursement including but not limited to government payers, commercial payers, and market specific payer changes.
• Completes multi-level analysis of contract language specific to quality measures to understand implication to Total Enterprise. Reviews complete existing and proposed contract language and identify current risk and impact to Total Enterprise.
• Maintains working understanding of Healthcare Effectiveness Data and Information Set (HEDIS) measures as well as local, regional, and national trends.
• Assists in the development and implementation of Atrium Health’s strategies and objectives related to quality across the continuum.
• Collaborates with various groups at all levels of the organization to maximize system performance and ensure proper monitoring, escalation, and resolution of any significant quality measure performance issue or trend.
• Serves on health system committees as it relates to quality, safety, population health and other associated committees.
• Partners extensively with Medical Group and Population Health executives to drive and achieve maximum performance for internal quality goals and value based contracts.
• Supports the creation and maintenance of provider performance improvement plans for both internal and external quality metrics, as well as risk contract goals as it relates to the quality HEDIS metrics and condition management and documentation (risk adjustment). Provides oversight and consultation to the strategic planning of clinical quality improvement initiatives. Guides and supports the quality team to achieve both internal and external goals by setting annual targets for clinical quality improvement.
• Establishes and maintains effective communication and working relationships within the QI department and with physicians, leadership and caregivers in markets and sites supported by Quality Improvement services. Provides input to leaders regarding goal setting, project improvement activities and work groups. Responds to concerns and provides problem resolution as appropriate.
• Manages and leads efforts to document, respond, quantify, follow -up, and report on all quality improvement activities and other quality projects as assigned. Designs and documents projects as assigned to effectively demonstrate the quality levels delivered to patients. Uses national, professional and/or local standards of care for comparisons when possible. Addresses health promotion, health maintenance, and health restoration in planning, implementing, and evaluating the quality improvement projects. 

 

Physical Requirements
 

 

Works in an office environment; requ