Quality Program Manager

Description

The Quality Program Manager is responsible for maintaining and improving the following quality improvement programs: NCQA Patient-Centered Medical Home, Meaningful Use Requirements, UDS Clinical Quality Measures, Health Plan and Paid-for-Performance Quality Incentive Program Measures, monitoring and working the Health Plans member rosters, and any other programs deemed essential for quality by Tri-Cities Community Health. In maintaining and improving these programs, the Quality Program Manager will gather data and report compliance and progress to the Quality Committee. The Quality Program Manager actively engages with the clinical teams and leadership in education and workflow processes to improve all our quality programs.  

Essential Functions

1. Coordinates, implements, and documents TCCH’s   quality/performance improvement program on an on-going basis, ensuring that   it is consistent with the requirements of governmental agencies such as HRSA,   health plans, and other accrediting agencies or associations that TCCH   participates in.

a. Work with management on the annual   quality/performance improvement plan and submit it to the TCCH Quality   Committee. 

b. Schedules and coordinates quality   committee and subcommittee meetings and prepares agendas for the meetings.   Collects or coordinates the collection of quality improvement data related to   metrics, trends, and outcomes to present to committees. Arranges for   collection of meeting minutes.

c. Supervises   the Continuous Quality (QI) Improvement activities of the clinical record   with practice sub committees of the QI program. 

d. Ensures that the quality improvement   program is designed to meet the various regulatory, health plans, and other   accrediting agencies that TCCH participates in.

e. Evaluates the quality improvement   program to assess effectiveness.

2. Works with All Health Plans to meet quality   expectations in the contracts.

a. Attend all meetings with the Health   Plans.

b. Ensure the rosters of each Health Plan   are maintained and used to meet our quality expectations set by the Health   Plans.

c. Report progress on each Health Plan   Paid-For-Performance reports up to the Quality Committee 

d. In coordination with the site mangers.   Ensure staff understand processes in place to meet the quality measures.

e. Work on process improvement with the   staff and leadership in order to achieve quality goals.

3. Oversee the patient satisfaction survey   process, report the results, and provide input on what can be done to   increase the level of patient satisfaction.

a. Communicates   with other managers the required survey sample size needed for reporting   purposes, Monitors and records the survey results received.

b. Prepares   monthly and quarterly patient satisfaction survey results along with patient   comments.

c. Communicates   the results of the surveys on a quarterly basis to Quality Committee.

4.  Assist Directors, Managers and   Site Leadership in developing process improvements to meet any of TCCH’s   quality program requirements. 

5. Support and/or perform reporting requirements to any outside agency to   meet quality program requirements. (Examples: HRSA/Grant renewal reporting,   UDS reporting, All Health Plan Paid-for-reporting plans)

6. Actively pursues and takes advantage of   educational opportunities to further his/her knowledge of areas of   responsibility or to become a more effective manager.

a. Shares information with peers and   staff in formal in-service programs or during team meetings.

b. Supervises and participates in   development/implementation of Critical Pathways/patient outcome plans.

c. Attends and participates in TCCH   committees and subcommittees as directed.

d. Acts as a resource for clinical   managers and staff.

7. Supports Site Managers with training and   development of Community Health Workers, including assisting with the   development of performance standards and goals.

8. Is responsible for the fiscal management of   the department and ensures the proper utilization of the organization’s   financial resources.

a. Develops   and monitors budget to stay within budget guidelines.

b. Effectively   utilizes resources within an established budget.

10. Demonstrates respect and regard for the   dignity of all patients, families, visitors, and fellow employees to ensure a   professional, responsible, an