Quality Operations Manager

🕒 vor 2 Tagen

🇺🇸 Vereinigte Staaten – Remote

💵 $84.000 - $120.000 / Jahr

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

⚙️ Operations

👻 Geisterscore 0%

infoinfo

🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of HarmonyCares

HarmonyCares

1001 - 5000 Mitarbeiter

Gegründet 1993

🏥 Gesundheitswesen

⚕️ Krankenversicherung

💰 Venture Round im 2021-11

Healthcare • Healthcare Insurance • Home Health

HarmonyCares ist ein führender Anbieter von umfassenden, häuslichen Gesundheitsdienstleistungen in 15 US-Bundesstaaten. Das Unternehmen ist spezialisiert auf ärztliche Betreuung zu Hause, qualifizierte Krankenpflege, Therapie und Hospizpflege für Patienten, insbesondere für diejenigen mit Medicare und komplexen medizinischen Bedingungen. HarmonyCares hat das Ziel, eine würdevolle, patientenzentrierte Pflege zu bieten, die es Einzelpersonen ermöglicht, ihre Gesundheit und Unabhängigkeit im Komfort ihres eigenen Zuhauses zu bewahren.

Beschreibung

• Maintain national quality playbooks and a shared knowledge base, updating guidance for annual measure/specification changes and field feedback • Analyze recurring closure misses and field questions, then implement workflow changes, job aids, and targeted education • Deliver provider and care team education, including new provider onboarding and continuing education • Align stakeholders and drive adoption of standard work across regions • Execute centralized EMR chart abstraction to identify qualifying evidence and document traceable evidence trails • Manage the Tier 2 escalation queue for complex denominator and closure documentation issues • Provide guidance and closed-loop resolution to Senior Population Health Managers • Support audit readiness through documentation standards, readiness checks, spot audits, and auditor-facing requests • Work with Senior Population Health Managers, Executive Directors, and clinical and administrative field teams • Contribute to enterprise quality targets, including 4+ Stars performance and comparable MSSP MIPS APP and ACO REACH goals

🎯 Anforderungen

• Bachelor’s degree or equivalent combination of education/experience in quality, population health, healthcare operations, or a related field • 4+ years of experience in MA Stars quality operations and measure execution • Current knowledge of Stars, MSSP MIPS APP, and ACO REACH quality program updates • Strong working knowledge of denominator logic, closure mechanics, acceptable evidence standards, and common failure modes • Proficiency locating discrete qualifying evidence and documenting a clear, traceable evidence trail while navigating EMR workflows • Strong PowerPoint skills • Advanced Excel skills • Experience developing enterprise playbooks, workflows, and job aids used across multiple markets or teams • Experience supporting clinical and field team education, including new hire onboarding and continuing education • Proficiency performing medical record review and chart abstraction • Experience operating in a matrixed environment with competing priorities and time-sensitive deliverables • Clinical credential (RN/LPN) or equivalent experience in HEDIS/Stars abstraction, coding, or health information management is preferred • Relevant certifications such as CPHQ, Lean/Six Sigma, or PMP are preferred • Experience supporting audit readiness activities is preferred • Experience with MSSP MIPS APP and ACO REACH quality programs is preferred

🏖️ Vorteile

• Health, Dental, Vision, Disability & Life Insurance • 401K Retirement Plan (with company match) • Tuition, Professional License and Certification Reimbursement • Paid Time Off, Holidays and Volunteer Time • Paid Orientation and Training • Great Place to Work Certified

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