Quality Manager

Position Overview

The Quality Manager is responsible for leading and directing the Quality department. They are responsible for quality improvement activities of the health center necessary to achieve and maintain the highest national performance levels. The Quality Manager will analyze data to support the decision making and ensure compliance with accrediting and regulatory agencies (HRSA, NCQA, CARF, CMS, etc.). The Quality Manager will work with the executive team to develop and implement strategies consistent with the organization.

Essential Duties and Responsibilities

• Ensures compliance, accreditation standards and documentation are met in all relevant areas of responsibility, i.e., CARF, PCMH, etc.
• Develops and implements data analytic programs to capture and extrapolate clinical and demographic data from the electronic health/dental record software.
• Participates in the development, execution and annual review of Quality policies, procedures and protocols.
• Actively participates on various internal committees and external community initiatives as required of position, or at the request of administration.
• Undertakes special projects as requested by administration.
• Captures and prepares the summary for the QA Board committee, including Service Recovery, service improvement and incidents.
• Coordinates the monthly meeting of the QA workgroup in conjunction with the Medical Director.
• Safeguards the interface from EHR to Wellcentive and EHR to date system.
• Creates/customizes pertinent reports using EHR, data systems, and registries for quality improvement.
• Participates as a member of the Safety Committee and reviews incident reports involving the safety of patients.
• Utilizes the quality database to enter all (patient, employee, visitor, etc.) incidents and outcomes.
• Functions as the organization’s Risk Manager in the absence of such and works on protocols and policies as necessary.
• Supervises and evaluates the work of Medical Records, Quality Specialists, Quality Analysts, Process Improvement, Quality CHW and Quality Referral Specialists.
• Acts as representative & liaison to Muskegon Family Care’s P.O – Affinia Health Network.
• Maintains regular communication with insurance provider representatives.
• Monitors all Uniform Data System Reporting for Clinical Quality measures.
• Enters data on insurance websites or faxes to insurance for services completed to ensure that service is included for incentives.
• Understands all aspects of HEDIS scores and reporting.
• Supports Patient Centered Medical Home initiatives in an effort to increase quality of care and Provider reimbursement.
• Completes Tables for the Annual UDS Report.
• Affirms FTCA Redeeming Application.
• All other duties as assigned.

Qualifications

• Bachelor’s degree in business administration, Organizational Development, Public Health or related discipline, OR an equivalent combination of education and experience.
• Minimum 5 years’ experience in Quality Improvement.
• PREFERRED: Certified Professional in Healthcare Quality (CPHQ).

About Muskegon Family Care

MFC is a Federally Qualified Health Center that aims to improve the overall health and wellness of our community by promoting the physical, emotional and spiritual well-being of our families through comprehensive healthcare and other essential services. As a community health center, we provide a range of services far greater than an ordinary doctor's office. We develop programs and services to meet the changing needs of our community, together we create a healthier community. We commit to serving our patient's and our staff through our ICARE values of innovation, within a compassionate environment for all, providing access to the care needed and treating all with great respect, and offering education opportunities that result in healthy outcomes. We are better together. Teamwork makes the Dreamwork.