Job Description

Location: Steward Health Care Network
Posted Date: 6/3/2022

Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world-class doctor close to where they live.

The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.

Position Purpose: The National Performance Manager has accountability and oversight of the training and field work of the performance team in collaboration with the Executive Director of National Performance Operations. This position is responsible for defining the strategy to appropriately close Quality and Risk Adjustment gaps at point of care for risk members nationally. Additionally, the National Performance Manager will lead the program development of a remote Central Operations team focused on telephonic engagement and medical record chart review, while collaborating with Regional Operations Teams.

  • Lead team of Performance Liaisons focused on operational efforts to improve the quality and risk performance scores for Steward Health Care Network
  • Leads process improvement to enhance physician and staff workflow. Accountable for medical record data review/collection for appeals and exclusions at the time of data submission per contractual obligations
  • Define strategy in each region for efficient patient outreach, roster management, and practice performance improvement while maintaining/leveraging the tracking system utilized across multiple teams. Heavy cross functional collaboration and communication to ensure efficiency in gap closure. Conducts regular review of current performance under each risk contract and sets the strategy and direction for the Performance Team to take in order to meet monthly targets
  • Works collaboratively with the SHCN Regional Operations team to coordinate improvement efforts related to overall performance. Accountable for the assessment of performance in relation to established goals and standards
  • Participates in the recommendation of new approaches, policies, workflows, and procedures to effect continual progress toward goals and standards
  • Implement performance improvement plans at the practice level while leading improvement within physician practices that will drive or have a direct impact on process improvements and enhancing clinical workflows
  • Produces and maintains records by keeping database up to date and reporting progress on a weekly basis and to determine impact of interventions. Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment and HEDIS measures
  • Consults with the Executive Director of Quality, Executive Director of National Performance Operations, and other stakeholders on the development of goals and standards that align with the strategic plan of SHCN. Provides expertise to develop and sustain process improvements at all levels of the organization. Provides dashboard reports to performance team, providers and practices and recommendations on improvement. Works collaboratively to solve problems, to improve processes, and to integrate services within physician practices
  • Maintain collaborative team relationships with peers and colleagues in order to effectively contribute to the working group's achievement of goals, and to help foster a positive work environment. Collaborates across functional departments to lead and implement changes/enhancements. Provides leadership in planning, reporting, evaluating, and facilitating improvement processes to increase effectiveness and efficiency in SHCN member practices. Manages the development of effective communication methods to keep staff and others informed about improvement activities of the practice
  • Coaches the regional and central performance team on the effective design and implementation of plans for continuous improvement and best practices within physician practices. Assists in preparation of training materials (internal or external). Present to key stakeholders, vendors and large groups
  • Other duties as assigned based on the needs of the business

Education / Experience / Other Requirements

Education:

  • Bachelor’s degree or equivalent experience preferred

Years of Experience:

  • 3-4 years of supervisory/management experience preferred
  • Clinical background (Medical Assistant or LPN) with coding (HCC/MRA) experience preferred
  • Experience in quality and risk adjustment preferred

Specialized Knowledge:

  • Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements, as well as HEDIS
  • Strong knowledge in Microsoft Office applications – Word, Excel, Access, PowerPoint

This position is subject to the COVID-19 Vaccination Policy for Steward Health Care Workforce. Employees in this position will be required to provide adequate proof of vaccination for COVID-19 by an FDA-approved vaccine prior to starting work. Steward will consider requests for exemptions from this vaccine requirement on the basis of medical condition or sincerely held religious belief in accordance with applicable Federal laws.

Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.


Additional Information

Steward Health Care Network is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment – with confidence and without fear.

Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience:

  1. Any COVID-19 related care takes place in designated areas away from other patients and their families.
  2. A stringent cleaning policy has been implemented throughout our facilities.
  3. A strictly controlled visitor and masking policy is required for patient and colleague safety.

You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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