Clinical Quality Manager - Population Health - Medicare Shared Savings Program (MSSP)

Bon Secours Health System; City of Schenectady (NY); Remote; USD 85,000 - 110,000; Full time

Job summary

A healthcare organization is seeking a Population Health Clinical Quality Manager to lead projects supporting value-based care. The role involves managing teams, engaging stakeholders, and overseeing healthcare quality initiatives. Candidates must have a current RN license and relevant experience in healthcare leadership. This remote position requires a strong background in data interpretation and EHR systems.

Benefits

Competitive pay

Incentives and bonuses

Medical, dental, and vision coverage

Paid time off

Tuition assistance

Qualifications

• Current RN License in the state.
• 7 years in healthcare leadership or quality.
• Proficiency in EHR systems.

Responsibilities

• Plan and manage quality performance projects.
• Lead a team for population health initiatives.
• Engage with stakeholders and present outcomes.

Skills

Proficiency in Excel

Data visualization

Expert knowledge of EHRs

Education

BSN or Bachelor's in Healthcare

MSN or Master's in Healthcare Administration

Tools

Excel

Tableau

Job description

Thank you for considering a career at Bon Secours Mercy Health!

Scheduled Weekly Hours: 40

Work Shift: Days (United States of America)

Overview

The Clinical Quality Team is a centralized Population Health team dedicated to ministry-wide support of our value-based contracts and gap closure work.

This Population Health Clinical Quality Manager will support the Medicare Shared Savings Program (MSSP) value-based care model.

Primary Function/General Purpose of Position

The Manager of Population Health Clinical Quality is responsible for planning, directing, executing and managing system-wide projects and initiatives to support quality performance across BSMH’s value-based care programs. This role supports growth of population health lives through initiatives focused on outreach, gap closure, and care across the patient continuum.

This is a remote/work-at-home position. Hire must be open to working Eastern Time Zone hours.

Essential Job Functions

• Leads system-wide population health projects and initiatives: identifying appropriate interventions and strategic solutions, leading change management planning efforts on assigned projects with the initiative owner(s), developing implementation plans and operational workflows, communication with stakeholders and executive leadership, anticipating change management needs, and plans for mitigating barriers.
• Provides subject matter expertise regarding value-based quality measures to system-level leaders, including enhancing value-based contract performance with the identification and validation of clinically relevant data.
• Leads the overall development, implementation, and delivery of the Population Health Clinical Quality strategic plan, including support of additional value-based lives, strategic growth, and identification of gaps across the continuum of care, while maintaining alignment with the overall ministry goals.
• Directs and leads a team of Population Health Coordinators in defined workflows to support quality outcomes and performance within BSMH’s value-based care programs.
• Develops and implements innovative processes and programs to optimize workflows and enhance quality outcomes through provider engagement, patient outreach, EHR workflows/reporting, and data analysis.
• Represents BSMH by actively participating in payer operations meetings, including Joint Operations Committees, with responsibility for providing updates on value-based contract quality outcomes and maintaining comprehensive understanding of contract requirements.
• Actively engages and represents Population Health Quality in various ACO/CIN Board Meetings and Quality Committees by providing regular presentations on the status of value-based quality processes and outcomes.
• Maintains operational oversight and accountability for Population Health patient outreach activities including affiliate provider partnerships and vendor management.
• Creates and maintains various data tracking tools and visualization platforms to support value-based program quality performance, support change initiatives, and engage stakeholders system-wide.

Licensing/Certification

• Current RN License in the state in which they are working or covered by compact (required)
• Certified Professional in Healthcare Quality (CPHQ) (preferred)
• Project Management Professional (PMP) (preferred)
• Lean Six Sigma (preferred)

Education

BSN or Bachelor's, Healthcare or related field (required)

MSN or Master's, Business, Healthcare Administration or related field (preferred)

Work Experience

• 7 years of business/healthcare experience in leadership, healthcare quality, and project management with proven career progressions.
• Experience in managed security service provider (MSSP), National Committee for Quality Assurance (NCQA), Centers for Medicare & Medicaid Services (CMS), Healthcare Effectiveness Data and Information Set (HEDIS) (required)
• 10 years' experience in business/healthcare leadership, healthcare quality, and project management with proven career progressions (preferred)
• Familiarity with Bon Secours Mercy Health systems and processes (preferred)

Skills

Display adequate proficiency in computer systems, including Excel, Outlook, Word, and PowerPoint.

Ability to manipulate, interpret, and visualize large sets of data in Excel, Tableau, etc.

Expert knowledge of Electronic Health Records (EHRs), preferably Epic.

Bon Secours Mercy Health is an equal opportunity employer.

We offer competitive pay, incentives, referral bonuses, and 403(b) with employer contributions, medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources, and discounts.

Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders, tuition assistance, professional development, and continuing education support.