DaVita Quality Initiatives Analyst (Downtown) in ALBUQUERQUE, New Mexico

Quality Initiatives Analyst (Downtown)

Description

DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Nevada, New Mexico, Florida, Colorado and Washington in its pursuit to deliver excellent-quality health care in a dignified and compassionate manner. As of June 30, 2016 DaVita Medical Group (formerly HealthCare Partners) provided integrated care management for approximately 760,000 patients. DaVita Medical Group’s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.

We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all.

If you're looking to make a difference with a large, financially stable, well-recognized medical group, DaVita Medical Group may be the employer for you.

Overview:

The Quality Improvement Manager functions tocollect and analyze data in order to assist the Clinical Quality Improvementteam in assessment of CMS STARS quality measures. Additionally, works withcorporate and health center leadership & staff to assist in improvingoutcomes in quality measures through outreach projects designed to improvecurrent clinical, utilization, and operational processes. Responsible forproviding facilitation, coordination and education for performance improvement(PI) activities for the Clinical Quality at ABQ Healthcare Partners (HCP).Develops, manages and implements initiatives to improve quality metric scores(PQRS / STAR / HEDIS /DSNP/CG-CAHPS/CHAPS/HOS) for ABQ HP patientsand monitors performance of the clinic physicians and intervenes to addressconcerns. Adheres to policies,procedures and regulations to ensure compliance and patientsafety. Participation in Compliance and other important training is acondition of employment.

Essential Functions:

  • Leadsand manages activities that result in improvement on various quality metrics includingHEDIS, P4P, STAR, HCC , ACOand other quality relatedactivities necessitated by health plan relationships.

  • Develops andimplements data collection and performance methodologies ensuring compliancewith HEDIS, PQRS /STAR/HEDIS/DSNP/CG-CAHPS/CHAPS/HOStechnical specifications, policies, operatingprocedures and goals in compliance with all guidelines.

  • Identifiesdata discrepancies and quality issues and works to ensure data consistency andintegrity.

  • Assistsin the preparation of the annual HEDIS compliance audit road map.

  • Completesaudit and submission requirements by HCP, NCQA, and other regulatoryentities.

  • Managesmedical record review process for quality metrics.

  • Preparesreports outlining conclusions and recommendations for quality metrics programimprovement and evolution.

  • Workson cross functional work teams to ensure successful PQRS/STAR/HEDIS/DSNP/CG-CAHPS/CHAPS/HOSpatient and physician rollouts.

  • Identifies opportunitiesto facilitate practitioner/clinician process and performance improvements.

  • Presents at providerand office staff meetings on topics related to quality metrics improvements.

  • Prepares anddisseminates written tools and communications to the physicians and theiroffice staff to help educate them on how to improve their quality metricsperformance.

  • Performs additionalduties as assigned.

Qualifications

Education:

  • Required- Bachelor’s Degree in relevant field.

Preferred- Master’s degree in Health Care Administration, Public Health, or related field. Formal education in project management.

Experience:

  • Required- Five (5) years’ experience in healthcare industry, managed care, project management and HEDIS.Principles and practices of health care service delivery, health care systems and medical administration

Preferred- Principles and techniques of effective supervision including training and evaluation of direct reports.

Knowledge Skills and Abilities:

  • Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer. Computer literate. Ability to operate Microsoft software (Project, Access, Excel, PowerPoint) and report writers. Succinct knowledge of medical group operations. Effective leadership and team-player capabilities. Demonstrated ability to conduct and interpret qualitative and quantitative analysis. Problem-solving skills. Excellent verbal and written communication skills. Excellent presentation skills. Demonstrated ability to exercise initiative and independent judgment. Valid driver’s license, insurance and vehicle for work-related travel.

DaVita Medical Group is an equal opportunity/affirmative action employer. As such, DaVita Medical Group makes hiring decisions solely on the basis of qualifications and experience, and without regard to age, race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.

We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.

DaVita Medical Group will consider qualified applicants who have criminal histories in a manner consistent with the law.

Primary Location NM-ALBUQUERQUE - 87102

Req ID: 309527