Quality Manager- Healthcare

Company Overview Essen Health Care, A patient-focused medical group. Our over 250 providers serve communities in the Bronx, Brooklyn, Queens, Manhattan, Long Island, Staten Island, and Westchester County. Essen Health Care is patient-focused and active in serving the community. For that reason, Essen uses the latest research to provide the highest quality of care to the underserved. Our over 20-year commitment to New York City has fueled an unwavering dedication toward innovating a better healthcare delivery system; one that truly makes a difference. Essen Health Care offers a fully integrated healthcare delivery network, and our goal to our valued patients is to provide only the highest level of quality care by leveraging our network of divisions, including Urgent Care, Primary Care, Specialty Care, House Calls, Care Management, and Nursing Home. Our vision and values guide every piece of the medical process. Concerns about cost? Quality? We Care for That. Essen is a part of the community it serves, and we understand the diversity of challenges and individual needs of New York City patients better than any other practice. With an ever-expanding variety of services, we can better meet the needs of New York City. Our network includes a range of specializations to meet the needs of all ages, all needs, and all divisions of the communities. Quality improvement managers may act as knowledge experts for continuous improvement activities in all clinical, functional and administrative areas. They monitor various department processes, such as care complaints and medical record assessments, in order to recommend actions to address any risks or vulnerabilities. Responsibilities Under the Director of Quality, manages primary aspects of quality program for the Health Home Division, inclusive of monitoring key health outcomes, establishing performance improvement projects, and resolution of gaps-in-care. Oversee quarterly audits, results and implement actions to address any identified improvement opportunities. Lead monthly QI meetings to ensure compliance and adherence to all metrics, policies and protocols. Manage implementation and execution of corrective action plans in response to program evaluation reports. Identify trends from standardized chart review tool(s) to enhance compliance of care coordination activities with all federal, state, local, and agency regulations. Supervise chart audit practices through development and maintenance of appropriate guidance/policy documentation of these processes. Synthesize data that aggregates quality projects outcomes (chart reviews, incident reports, gaps-in-care, quality scorecards, HEDIS measures, etc.) for the Health Home membership. Supports implementation and update of Federal, State, local, and payer policy/guidelines, inclusive of Health Home policies changes/updates. Develop written action plans using PDSA model to improve any deficits in documentation/records. Monitors execution of appropriate QI activities (e.g. staff training, coaching) to support quality oversight and ensure that corrective action plans are completed by target dates. Monitors quality metric benchmarks such as HEDIS measures, triple aim initiatives (reduce hospital and ER/ED visits; increase primary care connections). Oversee reportable incident protocol and review compliance with all incidents reports in accordance with lead health home and/or New York State Department of Health policies and recommendations. Support development and delivery of training/education to improve QA/QI outcomes. Attend system-wide quality initiative meetings, and all other out of system quality initiatives/conferences to represent Health Home program. Qualifications Master's degree in Social Work, Clinical Fields, Healthcare Fields (e.g. clinical/health/social). Minimum 3 years Managerial Experience and at least 5 years supervisory experience. Experience with quality and compliance, audits, Health Home, Medicaid and DOH regulations. Experience with population health and integrated care models. Experience with electronic health records (EHRs), Medicaid billing, ePACES, Medicaid Analytical Patient Portal (MAPP), Universal Assessment System (UAS). Proficient with Microsoft excel, including advanced skills with high level reports. Have a basic understanding of Care Management. Salary: $65,000-$80,000 Equal Opportunity Employer ESSEN HEALTH CARE IS PROUD TO BE AN EQUAL OPPORTUNITY EMPLOYER Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population. #J-18808-Ljbffr