Quality Manager
Job Details
Management
Long Beach Health Center - Suite 310 - Long Beach, CA
Full Time
BA
$71,063.00 - $91,694.00 Salary/year
Up to 25%
Day: 8am - 5pm
Health Care

POSITION SUMMARY:

APLA Health & Wellness (APLAHW) is seeking a qualified individual to provide leadership and expertise to ensure the delivery of safe, high quality patient care services at all clinical sites. APLAHW provides culturally competent medical, dental and behavioral health services to low-income individuals in Los Angeles County, with a specific focus on the LGBT community. Under the direction of the Associate Medical Director and the Director of Quality, oversees an agency-wide quality improvement program, with emphasis on services within the scope of the Federally Qualified Health Center.

                                                                                                              

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • In collaboration with the Associate Medical Director and the Director of Quality, executes and  maintains a performance measurement work plan and reporting calendar to ensure timely data collection, aggregation, analysis, and reporting of established clinical performance measures, including but not limited to HEDIS, STAR, UDS, etc. related to key operational and clinical processes and outcomes.
  • Coordinates execution and ongoing revision of the existing Quality Management Plan (QMP).
  • In collaboration with the Associate Medical Director and Director of Quality, facilitates the monthly Quality Risk Management Compliance meeting.
  • Coordinates effort of APLAHW to become and maintain a patient-centered medical home (PCMH) per National Committee for Quality Assurance (NCQA) standards.
  • Audits patients’ electronic health records for missing data; ensures data entered into (eClinicalWorks) is entered appropriately. 
  • Manages electronic storage of quality improvement reports to promote ongoing access for key stakeholders.
  • Coordinates HCCN and CCALAC reporting.
  • Contributes to SAC and OSV submissions.
  • Collaborates on annual UDS submission.
  • Collaborate with IT staffr on eClinicalWorks administration issues.
  • Collaborate on revisions to processes, protocols and policies.
  • Coordinates and oversees ongoing patient satisfaction data gathering and evaluation.
  • Collaborates with the Quality, Risk and Compliance staff in the investigation of clinical events including sentinel events, sentinel event near misses, and significant adverse events; leads and/or participates in the development of root cause analyses as directed by the Associate Medical Director.
  • Works closely with the Patient Navigators at each medical clinic, whose role is to enhance performance on key quality measures through patient navigation, health coaching, data management and reporting to clinical staff on performance and areas needing improvement.
  • Oversee and coordinate QI projects as assigned by the Associate Medical Director or Director of Quality.
  • Coordinate with outside consultants assisting with various quality improvement projects.
  • Train staff in Quality Improvement and processes as needed.
  • Oversees efforts to ensure that documentation captured accurately reflects services performed and complexity of care in order to maximize health plan and IPA reimbursements. Reconciles missing information with the appropriate plan or practice.
  • Represents APLA Health & Wellness at various community associations and meetings, including CCALAC, CPCA, NACHC, and others as appropriate.

                                                                                                     

OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.

REQUIREMENTS:

Training and Experience:

Possession of the following required: a Bachelor’s Degree in Public Health or a related field from an accredited college or university, or 4 year related experience required.  Master’s degree preferred. Supervisorial experience required in an outpatient family practice, internal medicine, or a Federally Qualified Health Center or community clinic preferred. Experience leading quality improvement teams preferred.  CPHQ Certification preferred.  Demonstrated ability to perform assigned responsibilities with minimum supervision; to maintain quality control standards; to interpret, adapt and apply guidelines and procedures. Strong verbal, written and interpersonal skills. Ability to develop and maintain cooperative relationships with staff members, patients and clinicians and work as a member of a multi-disciplinary team. Demonstrated ability to follow set routines and be alert to variations and make decisions accordingly. Sensitivity to racially, ethnically, culturally and sexually diverse populations; excellent oral and written communication skills; and knowledge of Microsoft Office. Experience with electronic health records (eClinicalworks preferred). Must possess current CPR certification.

 

Knowledge of:

Working knowledge of management methods and practices in a community clinic setting or similar health care facility. Knowledge of LEAN process improvement/Six Sigma preferred.  Experience in developing QM programs. Knowledge of NCQA Patient Centered Medical Home (PCMH) standards preferred. Basic knowledge of local, state and federal regulations relating to care of patients in a clinic setting, managed care, and Title 22 is preferred. Skill in identifying problems and recommending solutions in a clear, concise and proactive manner, including recognition and resolution of costly errors.  Demonstrated ability to set priorities and organize work responsibilities to insure completion of assigned tasks within agreed upon time span. Knowledge of common safety hazards and precautions sufficient to establish a safe work environment.

 

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

This is primarily an office position that requires only occasional bending, reaching, stooping, lifting and moving of office materials weighing 25 pounds or less. The position requires daily use of computer and requires entering, viewing, and revising text and graphics on the computer terminal and on paper.

 

SPECIAL REQUIREMENTS:

Must possess a valid California driver’s license; proof of auto liability insurance; and have the use of a personal vehicle for work related purposes.

 

COVID vaccination is required and APLA Health will consider accommodations for disability- and religious-based reasons.

 

Equal Opportunity Employer: minority/female/disability/veteran.    

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