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Manager - Quality Measurement

Company: Medica Health Plans
Location: Minnetonka
Posted on: September 13, 2020

Job Description:

The Manager of Quality Measurement is part of the Healthcare Economics Team. This position is in charge of leading a team to provide actionable information in support of priority programs at Medica and the overall efforts of the Healthcare Economics department. The manager provides analysis and reporting in support of clinical and quality programs, as well as Federal and State regulatory requirements.. Manage a team of three persons. Responsible for hiring and personnel changes, performance management, employee development and recongnition, and maintaining a high performing quality measurement team. Ability to manage home based employees as we navigate these uncertain times.. Manage relationships with vendors and regulatory agencies. Main point of contact for our HEDIS software vendor, HEDIS auditor, and for sending and receiving accreditation data to Federal and State regulatory bodies. Participate on external committees charged with improving quality measurement, including Minnesota Community Measurement.. Manage and submit the annual HEDIS and QRS reporting, including the compliance audit. Provide technical support for CAHPS and QHP enrollee surveys. Coordinate with the Health Services Department and external vendors on the chart review sample and chart chase logic. Stay current on regulatory requirements, and lead efforts to improve HEDIS and QRS measurement processes.. Maintain historical member-level quality measure results and benchmarks for the organization. Develop reporting processes that incorporate results from certified HEDIS software vendors, NCQA, CMS, and other sources. Lead efforts to expand electronic data collection and quality data sharing with provider partners.. Collaborate with all levels of management in Health and Physician Services, Network Management, Information Technology, Finance, and Market Business Segments to monitor key quality metrics in support of organizational priorities. Provide data and analytic support for Star Rating initiatives, State Public Programs measurement improvement efforts, and other organizational quality improvement activities.. Qualifications:. Bachelor's Degree, graduate degree preferred; or equivalent experience. Major: Health Services Research, Public Health, Health Care Administration, Epidemiology or health-related fields. 8+ years of experience in the field. Skills & Abilities:. Management experience; ability to coach professional staff. Vendor management experience; ability to manage relationships, evaluate performance, and negotiate contracts. Strong knowledge of the health care industry, HEDIS production, and electronic clinical data systems. Ability to explain quality measures and related processes in layman’s terms. Ability to manage multiple projects and priorities; comply with tight deadlines.. Excellent written and verbal communication skills and listening skills. Creative problem solving, thinking outside the box.. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). Medica Health Plans - 1 day ago - save job. Get job updates from Medica Health Plans. Thousands of employers search for candidates on Indeed

Keywords: Medica Health Plans, Minnetonka , Manager - Quality Measurement, Other , Minnetonka, Minnesota

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