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Position:

Director, Quality Solutions

Position Summary:

Provides guidance and direction for quality across the department. Develops programmatic approaches to improving performance under risk-adjusted value-based contracts across multiple lines of business. Responsible for overseeing the development of client programs to yield best practices for defining and prioritizing quality measurement completion and accurate documentation of patient interventions and encounters, as well as helping Lumeris in-market teams operationalize the programs, and informing the solution strategy and roadmap. Guides the team responsible for development of quality plans and supporting implementation and ongoing management of the quality measurement optimization at the local market level.

Job Description:

Primary Responsibilities

• Supervises the day-to-day activities and coaches, mentors, motivates, supports, and develops one of more individual contributor(s). Participates in and/or supports performance management/corrective action plans, goal setting/review, regular guidance and 1-1 check ins, career development/planning, upskilling, resource allocation, DE&I initiatives, and other People & Culture programs/activities as needed.  Fosters accountability and collaboration to ensure team member and overall team success.
• Impacts internal strategy by developing and continuously improving the design of the Lumeris Quality Plan programs for multiple lines of business (Medicare, Medicaid, Commercial). Provides ongoing guidance to in-market team members in order to create continuous improvement.
• Stays abreast of industry changes and learnings in the field of quality measurement to evolve the strategy over time as well as align with supporting initiatives and strategies across value based care populations.
• Oversees Lumeris quality plan solutions delivery.
• Monitors current accounts and collaborate across the organization to ensure that the Lumeris programs reflect organizational continuous learnings. Ensures alignment across departments and lines of business around the quality measures strategy and operating model to ensure efficiency in programs at point of care as well as through technology and extended settings of care.
• Partners cross-functionally to identify opportunities for enhancement of Lumeris solutions and capabilities (technology, analytics, and services) for targeted optimization interventions.
• Oversees the quality measures programs for Lumeris clients and provides expertise for development of client solution design during the strategic consulting phase of client engagements.
• Collaborates cross-functionally to ensure success of executing the plan in the market that results in optimizing quality performance across value based care populations.
• Serves as a point of escalation and provides subject matter expertise to help resolve issues.
• Participates in the governance of Lumeris' account portfolios to monitor account performance and identify opportunities for improvement.
• Cultivates strategic partnerships both internally and externally by acting as a consultant "trusted advisor" for quality measurement best practices.

Qualifications

• Bachelor's degree or equivalent
• 12+ years of relevance experience in a managed care or value-based care delivery setting or the knowledge, skills, and abilities to succeed in the role
• Demonstrated advanced knowledge of value-based care delivery 
• Deep knowledge of value-based care quality measurement  models and ability to extrapolate meaningful content from multiple contracts in order to support development of an induvial client annual quality plan
• Highly skilled at working with physician groups and health systems to improve quality measurement plan development and execution
• Highly polished verbal and written communication abilities
• Expert collaborator and facilitator
• Demonstrated strategic and consultative approach to creating solutions and engaging with partners 
• Proven ability to successfully build and cultivate excellent long-term relationships
• Demonstrated ability to pri