Quality Operations Manager

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $84k - $120k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

👻 Ghost score 0%

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HarmonyCares

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1993

🏥 Healthcare

⚕️ Healthcare Insurance

💰 Venture Round on 2021-11

Healthcare • Healthcare Insurance • Home Health

HarmonyCares is a leading provider of comprehensive, home-based healthcare services across 15 states in the U. S. The company specializes in in-home physician care, skilled nursing, therapy, and hospice care for patients, particularly those with Medicare and complex medical conditions. HarmonyCares aims to offer dignified, patient-centered care, allowing individuals to maintain their health and independence in the comfort of their own homes.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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