Quality Program Manager, Medicare ACO
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 Quality Program Manager, Medicare ACO oversees all aspects of the Medicare ACO quality program. Reporting to the National Executive Director of Quality, this role interfaces with cross-functional teams to coordinate the operational support and resources needed to reach both quality measure specific goals, as well as, the overall quality program performance goal.
- Develops annual quality plan for each participating region and ensures sound operational plans are in place to achieve quality performance goals
- Reviews and analyzes national as well as regional quality performance reports to identify risks and opportunities. Develops mitigation plans in partnership with operational areas to address performance deficits
- Works with analytic and reporting teams to ensure appropriate reports, performance drill-downs and data analysis are produced to increase efficacy of performance improvement efforts and to facilitate attainment of quality program goals
- Partners with Quality Reporting team to complete all regulatory reporting accurately, completely and by the CMS defined deadlines
- Supports national and regional leads in the execution of both performance improvement efforts and meeting reporting requirements
- Completes all CMS audits accurately and by the CMS deadline.
- Performs all other duties as assigned based on business need
Education / Experience / Other Requirements
- Bachelor's degree, RN, LPN, CPHQ, CCS, CCS-P, RHIT, RHIA, CDEO, CPMA, CPC, CRC, CHCA or similar credential is preferred
Years of Experience:
- Seven (7) or more years of experience in health care in quality focused roles that included Medicare populations
- Strong computer skills, i.e., using various software, including intermediate Excel skills (sort, filter, reformat data, etc.)
- Strong analytic skills/ability to translate complicated data into useable information, including analysis of practice variation
- Successful experience managing complex projects beginning to end with accountability for outcomes, demonstrated organizational and management skills to manage complex projects through effective planning, tracking, and resource allocation to meet business objectives and timelines
- Strong leadership and management skills; self-directed
- Ability to generate creative solutions
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.
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:
- Any COVID-19 related care takes place in designated areas away from other patients and their families.
- A stringent cleaning policy has been implemented throughout our facilities.
- 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.