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Manager, Quality Improvement Accreditation

Job Category:  Clinical
Department:  Quality Improvement
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  7073

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

 

As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.

Job Summary


The Manager of Quality Improvement Accreditation is an experienced healthcare professional responsible for managing activities associated with Accreditation, the use of ongoing monitoring and analysis of plan performance, to facilitate the design and implementation of clinical and service related quality improvement studies and activities in support of the Quality Improvement Plan and strategic objectives of the organization.  

 

Position activities involve frequent day to day interface with Plan Partners, regulatory agencies and internal L.A. Care departments in support of established accreditation standards, quality improvement activities including budgetary and other resource components associated with annual Healthcare Effectiveness Data and Information Set (HEDIS) studies, and ongoing development of policies and procedures. Serves as the departmental point of contact in the absence of the Director. The position reports directly to the Director of Quality Improvement/Accreditation.

Duties


Manage the research, analysis and project management (monitoring and evaluation) in support of accreditation, quality initiatives and outcomes of the quality improvement program requirements and organizational strategic initiatives. Develop well formulated plans and implement quality improvement activities to improve outcomes of performance related identified important aspects of care and service relative to the population served.

 

Identification and procurement of personnel, budgetary and contractual requirements associated with quality improvement programs and ongoing member and provider satisfaction initiatives, and to ensure members are getting the appropriate care and services.

 

Facilitate ongoing education of internal staff, temporary staff, Plan Partners regarding quality improvement activities, including but not limited to accreditation, Consumer Assessment of Healthcare Providers and Systems (CAHPS), access and availability, member satisfaction and other Quality Improvement Activities.


Manage organizational approach to quality improvement activities;  continuously identification of opportunities for improvement with appropriate corrective actions, reduction in duplication of efforts, improved outcomes, improved Plan Partner and overall plan performance.

 

Oversee and participate in medical staff committee activities including meetings, program and standards development. Timely inception, development, review and evaluation of effectiveness of guidelines and standards. 

Manage staff, including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.

 

Perform other duties as assigned.

Education Required

Bachelor's Degree
In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Master's Degree

Experience


Required:
At least 5-7 years of operational and/or clinical management experience within health care systems, primarily in a managed care environment, preferably with relevant Quality Improvement/Quality Management experience.

 

Minimum of with 3-4 years of supervisory/management experience. 

Skills


Required:
Knowledge of regulatory and accreditation requirements.

 

Technical knowledge of quality improvement HEDIS and National Committee for Quality Assurance (NCQA) standards.

 

Proficiency with MS Office and other computer programs relevant to the performance of the position.

 

Demonstrated ability to manage, organize and analyze data.

 

Excellent interpersonal, written, verbal and presentation skills.

 

Demonstrated ability to lead a team to successful and timely achievement of organizational objectives.

 

Good organizational skills. 

 

Possesses a strong quality improvement background that includes managed care and NCQA, specifically within the Medicaid and government sponsored programs environments.

 

Persuasion Skills: Emphasize value or impact of stakeholders in the success of intervention/activity in improving the overall care of members served. Interacting regularly with others within and outside of the organization to create a collaborative quality improvement project creates significant challenge as such  need to persuade others to work on common goal is difficult given the diffuse network and resource allocation to QI activities. Therefore, it is important to cause understanding by others or to exercise influence with them. One needs to be persuasive, assertive as well as sensitive to others points of view.

Licenses/Certifications Required

Licenses/Certifications Preferred

Certified Professional in Healthcare Quality (CPHQ)

Required Training

Additional Information


Financial Impact: Success of programs as evidenced by outcomes and performance rating of plan will lead to increased satisfaction and member and provider retention.

 

Preferred:
Formal certification/licensure in one or more areas of professional expertise.

 

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)

 

At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.


Nearest Major Market: Los Angeles

Job Segment: Medical, Medicaid, Healthcare

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