Partnership HealthPlan of California
Director of Quality Management
Partnership HealthPlan of California, Fairfield, California, United States, 94533
Overview
Under the direction of the Senior Director of Quality and Performance Improvement (QI/PI), theDirector of Quality Management is responsible for directing plan-wide and regional performanceimprovement initiatives, quality incentive programs, and quality improvement data visualizationtools and analyses. This includes, but is not limited to strategic goal setting, program planning,budget/account management, and supervision of teams. Responsibilities
Direct Partnership’s performance improvement activities, conducted by regional performanceimprovement teams and others in the quality department. Activities include large-scalenetwork wide initiatives, DHCS mandated improvement projects, elective improvementprojects conducted with internal and external partners, and initiatives specific to engagingmembers and improving member experience. Assure ongoing prioritization, progress, evaluation, and monitoring of network wide andregional project portfolios to assure short term tactical plan objectives under the Partnership 5-Star Quality Strategy are achieved. Direct knowledge management processes andinventories to inform multi-year intervention strategies in quality measure scoreimprovement. Ensures all interventions are measured for effectiveness and efficiency, with timelyanalysis and reporting. Assures initiatives and programs are evaluated at an appropriatefrequency with comprehensive, data driven reporting, conclusions, and recommendations. Oversee the delivery and ongoing development of Partnership’s Partnership ImprovementAcademy and its associated programs. Direct Partnership’s Primary Care, Hospital, Perinatal, Palliative, Enhanced Case Management,and Long Term Care Quality Incentive Programs, also known as Quality ImprovementPrograms (QIPs). The QIPs provide financial incentives, data, and technical assistance toour provider network for meeting performance improvement targets. Research, develop strategies, and advise on QIP payment and incentive methodologiesfor enhancing existing programs to align with the Partnership 5-Star Quality Strategy. Initiatenew pay for performance programs, as needed. Direct the maintenance and enhancement of Partnership’s provider level quality datavisualization and analysis program, the Partnership Quality Dashboard. Work closelywith Quality Improvement Analysis team, other leadership across QI department andPartnership as a whole on data and measurement related activities, including the QIPs, PartnershipStars Dashboard, provider reporting tools, and internal dashboards and programevaluations. Lead, develop, and coach the leadership of Partnership’s Performance Improvement teams,quality incentive programs (QIPs), and Quality Improvement Analysis teams in thehiring, training, coaching, and support of staff. Assure robust communication and ongoing collaboration is achieved with sponsors,stakeholders, leadership, staff, and external partners involved in performanceimprovement initiatives and project portfolios across the organization. Stay informed on key developments in the quality improvement field that impact ourprovider network, including patient-centered medical home certification criteria,meaningful use, primary care transformation best practices, and quality reportingrequirements. Partner closely with the Director of Quality Measurement to strengthen communication,understanding, and decision-making in how changes to NCQA and DHCS measure setsinform performance improvement priorities, QIP measure development, and datavisualization in Partnership Quality Dashboard (PQD). Foster strong partnerships between QI, Health Analytics, IT, and Population Health tofulfill data collection, reporting, and dashboard needs in achieving QI/PI deliverables andrelated organizational goals, while addressing competing priorities and assuring goodstewardship of technical resources. Serve as a member of QI Department and Health Services Management Teams:
Support Senior Director in budget management, staffing decisions, and strategicand operational planning. Serves as a key contributor to maintaining and advancing progress under Partnership’s5-Star Quality Strategy and corresponding tactical plans, work plans, anddepartment goals. Support development of direct reports and other department staff by establishingclear goals, expectation, and metrics on all projects. Accept other responsibilities as determined by the needs of the QI department.
Other duties as assigned. Qualifications
Education and Experience Bachelor’s degree in applicable field required; Master’s degree inhealthcare is strongly preferred. Formal certification in areas ofprofessional expertise such as Lean Six-Sigma, IHI’s ImprovementAdvisor Program, and training in the Model for Improvement isdesirable. Minimum of three (3) years management experiencerequired. Experience should include managing multifaceted quality andperformance improvement projects. Working knowledge of principlesand techniques of effective management, including training andevaluation. In depth knowledge of Quality ImprovementMethodologies. Special Skills, Licenses and Certifications Ability to lead and motivate teams in achieving superior performancewhile assuring professional development of staff. Superiorcommunication skills, adaptability, openness to feedback and newideas. Excellent project management skills, including project planning,resource allocation, and completion status tracking and reporting.Strong critical thinking and data analytic skills are required. Advanceddata analytic skills in healthcare quality data are desired. In depthknowledge of improvement methodologies such as the Model forImprovement, Lean, Six Sigma. High level of proficiency in MS Word,Excel, Outlook, and Visio are minimum requirements. Proficiency inMS Project, Tableau, and reporting software desirable. Valid Californiadriver’s license and proof of current automobile insurance compliantwith Partnership policy are required to operate a vehicle and travel forcompany business. Performance Based Competencies Strong written and oral communication skills. Excellent interpersonalskills to build relationships and communicate with the Partnership providernetwork, various Partnership regional offices, and other Partnership departments.Ability to teach and coach diverse healthcare leadership and staff onquality management projects. Strong organizational skills to work onmultiple projects simultaneously within established time frames. Stronganalytic and critical thinking skills. Demonstrated skills in facilitation,consensus building, conflict resolution, and identification of concreteaction steps. Work Environment And Physical Demands Must be able to work in a fast paced environment and maintaincourtesy and composure when dealing with internal and externalcustomers. Ability to function effectively with frequent interruptionsand direction from multiple team members. More than 50% of worktime is spent in front of a computer monitor. When necessary, theability to lift, carry, or move manuals and reports, weighing up to 25lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan’s policies and procedures, as they may from time to time beupdated. HIRING RANGE: $180,252.50 - $243,340.87 IMPORTANT NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.
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Under the direction of the Senior Director of Quality and Performance Improvement (QI/PI), theDirector of Quality Management is responsible for directing plan-wide and regional performanceimprovement initiatives, quality incentive programs, and quality improvement data visualizationtools and analyses. This includes, but is not limited to strategic goal setting, program planning,budget/account management, and supervision of teams. Responsibilities
Direct Partnership’s performance improvement activities, conducted by regional performanceimprovement teams and others in the quality department. Activities include large-scalenetwork wide initiatives, DHCS mandated improvement projects, elective improvementprojects conducted with internal and external partners, and initiatives specific to engagingmembers and improving member experience. Assure ongoing prioritization, progress, evaluation, and monitoring of network wide andregional project portfolios to assure short term tactical plan objectives under the Partnership 5-Star Quality Strategy are achieved. Direct knowledge management processes andinventories to inform multi-year intervention strategies in quality measure scoreimprovement. Ensures all interventions are measured for effectiveness and efficiency, with timelyanalysis and reporting. Assures initiatives and programs are evaluated at an appropriatefrequency with comprehensive, data driven reporting, conclusions, and recommendations. Oversee the delivery and ongoing development of Partnership’s Partnership ImprovementAcademy and its associated programs. Direct Partnership’s Primary Care, Hospital, Perinatal, Palliative, Enhanced Case Management,and Long Term Care Quality Incentive Programs, also known as Quality ImprovementPrograms (QIPs). The QIPs provide financial incentives, data, and technical assistance toour provider network for meeting performance improvement targets. Research, develop strategies, and advise on QIP payment and incentive methodologiesfor enhancing existing programs to align with the Partnership 5-Star Quality Strategy. Initiatenew pay for performance programs, as needed. Direct the maintenance and enhancement of Partnership’s provider level quality datavisualization and analysis program, the Partnership Quality Dashboard. Work closelywith Quality Improvement Analysis team, other leadership across QI department andPartnership as a whole on data and measurement related activities, including the QIPs, PartnershipStars Dashboard, provider reporting tools, and internal dashboards and programevaluations. Lead, develop, and coach the leadership of Partnership’s Performance Improvement teams,quality incentive programs (QIPs), and Quality Improvement Analysis teams in thehiring, training, coaching, and support of staff. Assure robust communication and ongoing collaboration is achieved with sponsors,stakeholders, leadership, staff, and external partners involved in performanceimprovement initiatives and project portfolios across the organization. Stay informed on key developments in the quality improvement field that impact ourprovider network, including patient-centered medical home certification criteria,meaningful use, primary care transformation best practices, and quality reportingrequirements. Partner closely with the Director of Quality Measurement to strengthen communication,understanding, and decision-making in how changes to NCQA and DHCS measure setsinform performance improvement priorities, QIP measure development, and datavisualization in Partnership Quality Dashboard (PQD). Foster strong partnerships between QI, Health Analytics, IT, and Population Health tofulfill data collection, reporting, and dashboard needs in achieving QI/PI deliverables andrelated organizational goals, while addressing competing priorities and assuring goodstewardship of technical resources. Serve as a member of QI Department and Health Services Management Teams:
Support Senior Director in budget management, staffing decisions, and strategicand operational planning. Serves as a key contributor to maintaining and advancing progress under Partnership’s5-Star Quality Strategy and corresponding tactical plans, work plans, anddepartment goals. Support development of direct reports and other department staff by establishingclear goals, expectation, and metrics on all projects. Accept other responsibilities as determined by the needs of the QI department.
Other duties as assigned. Qualifications
Education and Experience Bachelor’s degree in applicable field required; Master’s degree inhealthcare is strongly preferred. Formal certification in areas ofprofessional expertise such as Lean Six-Sigma, IHI’s ImprovementAdvisor Program, and training in the Model for Improvement isdesirable. Minimum of three (3) years management experiencerequired. Experience should include managing multifaceted quality andperformance improvement projects. Working knowledge of principlesand techniques of effective management, including training andevaluation. In depth knowledge of Quality ImprovementMethodologies. Special Skills, Licenses and Certifications Ability to lead and motivate teams in achieving superior performancewhile assuring professional development of staff. Superiorcommunication skills, adaptability, openness to feedback and newideas. Excellent project management skills, including project planning,resource allocation, and completion status tracking and reporting.Strong critical thinking and data analytic skills are required. Advanceddata analytic skills in healthcare quality data are desired. In depthknowledge of improvement methodologies such as the Model forImprovement, Lean, Six Sigma. High level of proficiency in MS Word,Excel, Outlook, and Visio are minimum requirements. Proficiency inMS Project, Tableau, and reporting software desirable. Valid Californiadriver’s license and proof of current automobile insurance compliantwith Partnership policy are required to operate a vehicle and travel forcompany business. Performance Based Competencies Strong written and oral communication skills. Excellent interpersonalskills to build relationships and communicate with the Partnership providernetwork, various Partnership regional offices, and other Partnership departments.Ability to teach and coach diverse healthcare leadership and staff onquality management projects. Strong organizational skills to work onmultiple projects simultaneously within established time frames. Stronganalytic and critical thinking skills. Demonstrated skills in facilitation,consensus building, conflict resolution, and identification of concreteaction steps. Work Environment And Physical Demands Must be able to work in a fast paced environment and maintaincourtesy and composure when dealing with internal and externalcustomers. Ability to function effectively with frequent interruptionsand direction from multiple team members. More than 50% of worktime is spent in front of a computer monitor. When necessary, theability to lift, carry, or move manuals and reports, weighing up to 25lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan’s policies and procedures, as they may from time to time beupdated. HIRING RANGE: $180,252.50 - $243,340.87 IMPORTANT NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.
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