Quality Improvement Program Advisor III

Location: Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California

Accepting applications through Friday, April 11th at 5:00PM.

We have an opportunity to join the Alliance as a Quality Improvement Program Advisor III in the Quality Improvement and Population Health Department.

ABOUT THIS POSITION

This position sits within the Quality and Population Health team under the Quality Improvement and Population Health Department at the Alliance. This role will support primary care providers; answer questions about the Alliance's pay-for-performance Care-Based Incentive (CBI) program; validate and investigate data for CBI measures and the Alliance's provider portal; create and present CBI program material, clinic-specific rates and best practices with providers clinics; support updates to program material; train clinics on related quality improvement resources; create reports; and support other QI projects as needed. This position is an advanced working level classification with a greater knowledge of quality improvement initiatives, greater independence, and responsibility with assisting with mentoring and training of lower-level Quality Improvement Program Advisor positions.

Reporting to the Quality and Population Health Manager, this position:

• Leads the planning, implementation and management of select Quality Improvement (QI) programs, such as Healthcare Effectiveness Data and Information Set (HEDIS), Performance Improvement, and the Alliance's pay-for-performance (Care Based Incentive) program
• Provides proactive, strategic consultative solutions related to QI projects that include population health and program evaluation and partners with management, project managers, and ITS to develop, implement and manage a defined QI project portfolio
• Provides subject matter expertise and assists with providing mentoring and training

THE IDEAL CANDIDATE

• Thorough knowledge of NCQA HEDIS measures and data analysis
• Working knowledge of the concepts of Medi-Cal managed health care
• Experience working with providers and clinic staff on quality performance measurement and improvement
• Excellent communication and interpersonal skills with emphasis on collaboration

WHAT YOU WILL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

• Knowledge of:
  
  
  
  • The tools and techniques used to perform analysis of large data sets, including:
    
    
    
    • Statistical software such as SAS/MiniTab/R/Python/SQL
    • Program outcomes evaluation metrics such as National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), Agency for Healthcare Research and Quality (AHRQ), and/or LeapFrog
    
    
    
    
  • A variety of quality initiative techniques applicable to HEDIS, CBI and QI projects
  • Healthcare industry and healthcare information standards such as HL7, LOINC, FHIR, ICD 9/10 and CPT codes, industry standard groupers such as ETGs, DRGs, and DCGs
  • Health plan and delivery system operations, healthcare informatics, healthcare benefits and terminology, and medical practice operations
  
  
  
  
• Ability to:
  
  
  
  • Plan, organize, and lead data collection and analysis activities
  • Present statistical and technical data in a clear and understandable manner utilizing appropriate visual aids
  • Foster collaborative working relationships with individuals at all levels of the organization and with community partners, providers and other external stakeholders
  • Identify and analyze database and data processing problems specific to QI projects and recommend solutions
  
  
  
  
• Education and Experience:
  
  
  
  • Master's Degree in Business, Healthcare, Data Science or a related field, or Black Belt certification in Six Sigma DMAIC to serve as an equivalent
  • Completion of training in process improvement methodologies and change management principles
  • Or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities may be qualifying
  
  
  
  

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).