Job Description

Job Description
Location: Steward Health Care Network

Posted Date: 3/16/2021

Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world class doctor close to where they live.

The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.

Position Purpose: This position works in close collaboration with the Executive Director of Quality to drive a successful government quality program. While focusing on meeting all regulatory requirements, this role will require achieving the performance goals set forth by Steward Health Care Network (SHCN) specific to these programs. To be successful, this role must closely align with cross-functional business partners providing expertise on how to maximize quality performance, closely monitor program performance, and identify and address performance opportunities.

* Leads the charge in implementing an integrated and organizational-wide approach to maximize government quality performance via a strategic plan that aligns to the mission, vision and values of the organization.
* Monitors program performance and take action to ensure government quality programs achieve organizational performance targets
* Drive the professional growth and development of the team through mentorship and regular 1:1 meetings to ensure all team members are set up for success.
* Work closely with quality team members to deliver accurate and complete contractual quality reporting to CMS, state, and state contracts
* Consult and guide Clinical Quality teams for quality improvement program design and development.
* Support implementation of clinical quality projects, including estimating size of the population, potential impact, monitoring progress, reporting and evaluation.
* Provide, in collaboration with Clinical Quality teams, requirements for clinical quality data infrastructure to support clinical quality measurement and reporting activities.
* Work closely with hospital division counterparts to ensure successful development and execution of joint initiatives to improve quality performance
* Proactively monitor vendor-managed programs to ensure compliance with service level agreements and quality outcomes.
* Oversee grievance program and incentive and benefit program per the policy and procedures for these programs
* Participate in internal program audits as well CMS and/or state quality program audits
* Other duties as assigned based on business needs

Education / Experience / Other Requirements

Education:

* Bachelor's degree required
* Master's degree strongly preferred

Years of Experience:

* Seven (7) years in health care quality focused roles
* Significant experience in analytic functions, quality assessment, HEDIS measurement, use of claims data, medical record review and clear advancement in responsibilities and outputs is preferred
* Excellent verbal and written communication skills

Specialized Knowledge:

* 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. Knowledge of methods used for improving employee performance/motivation.
* Ability to generate creative solutions, identify the best course of action and rapidly resolve complex issues/problems
* Skill in resolving employee/customer conflicts and complaints in a mutually satisfactory way
* Ability to communicate clearly with employees at all organizational levels, and across differing cultural backgrounds

Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.

Additional Information

Steward Health Care Network is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment - with confidence and without fear.

Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience:

1. Any COVID-19 related care takes place in designated areas away from other patients and their families.
2. A stringent cleaning policy has been implemented throughout our facilities.
3. A strictly controlled visitor and masking policy is required for patient and colleague safety.

You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.