Job Description

Location: Steward Health Care Network
Posted Date: 5/26/2023

Position Purpose: The Regional Performance Manager analyzes quality and clinical reports for each assigned medical practice and works in close partnership with the assigned medical practice to develop an annual performance improvement plan based on each medical practice’s identified strengths and opportunities. The Regional Performance Manager will work closely with the medical practice throughout the performance period to monitor, support, and revise the annual plan to ultimately ensure that each assigned medical practice achieves the target for all network performance metrics. This position also interfaces with the regional operations team and works as part of the national quality and performance teams to drive performance excellence in each assigned medical practice.

  • Reviews and analyzes monthly performance reports assessing performance in nationally identified clinical and quality metrics. Identifies performance strengths and opportunities.
  • Build strong business relationships with each assigned medical practice and clearly communicates the network metrics and goals to each assigned medical practice.
  • Acts as a quality measure subject-matter expert for all assigned medical practices and stays up-to-date on new quality measures, updates to existing quality measures, as well as payer specific requirements and submissions
  • Acts as subject matter experience on risk adjustment related clinical performance and stays up-to-date on payer specific submissions and requirements
  • Develops, implements, and supports performance improvement roadmap for each assigned practice that aligns all the cross-functional team objectives, including but not limited to practice goals, regional operations goals, the national quality team goals, and the national performance team goals
  • Collaborates on payer meetings surrounding regional performance and strategy
  • Additional responsibilities as needed based on business need.

Education:

  • Bachelor's degree, RN, LPN, CPHQ, CCS, CCS-P, RHIT, RHIA, CDEO, CPMA, CPC, CRC, CHCA or similar credential

Years of Experience:

  • Four (4) or more years of experience in health care quality focused roles that included medical record audits and/or performance metric i.e., HEDIS, Stars, or similar Significant experience in quality measurement, HEDIS, interpretation of claims data, medical record review

Specialized Knowledge:

  • 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 project 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

Application Instructions

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