Manages day-to-day operations of the population health, quality and outcomes management programs; manages RN, LPN Care Coordinators, and Clinical Care Partners workflows, data reporting, TCM processes, and applicable team members.  Meets with providers, clinicians and staff to communicate information, educate on quality areas of focus, and plan and implement quality focus groups and initiatives.  Oversees and is responsible for data reporting, including database management, data abstraction and trending, and report distribution. Trains staff and holds accountable to ensure effective and efficient performance of functions.  Incumbent responsible for improving quality initiatives for population served.

Job Standards and Performance Expectations

1. Performance Improvement and Quality
   1. Reporting/Communication:  Reports data timely and accurately.   Ensures HLN gap closure spreadsheet, TCM workflow and reports, payer reports, quality initiative reports are reviewed and distributed per calendar schedule.  Oversees distribution of reports and deadlines for reporting data. Provides graphs, charts, written communication to relay quality outcome information.  Runs reports from EPIC system and trends data and identifies changes for improvement in compliance.
   2. Quality Initiatives:  Coordinates abstraction of data from open and closed medical records or other information system sources.  Responsible for maintaining database of data elements and compiling other reports as requested. Actively assists Administrator and Physician Quality lead with education of data results and workflow to achieve the measures with a special emphasis on HLN. Works in collaboration to report and oversee outcomes of the quality initiatives on a monthly basis.
   3.  Training/ Education:  Develops and performs orientation for Clinical Care Partners and LPNCCs.  Assists with educating clinic staff on their roles in quality.   Proofs materials for accuracy.  Attends all necessary in-services and meetings to keep up to date changes. Educates on quality metrics and workflow to achieve those measures.  Develops and implements CCP workgroup sessions throughout the year, CCP monthly meetings, and any other training needed to re-educate team members.
   4. Management: Manages LPNCC and CCP staff members with population health assignments and daily operations. Conducts time keeping and performance evaluations.  Works with clinics leaders to interview and hire CCPs for their clinics.  Openly communicates and works closely with management on processes and workflow.
   5. Care Coordination:  Conducts ongoing quality metric and quality initiative education to staff and oversight of CCP, LPNCC and TCM roles/workflow.  Works in collaboration with management to standardize workflows for: CCP, LPNCC, and TCM roles.  Works with colleagues on market standardization. Responsible for compiling clinic specific or clinician specific quality data into written reports for the purpose of education.  Communicates with management on findings or ways to improve processes.
2. Reporting and Quality Metrics
   1. Oversees all reports that need to be run, reviewed, and distributed on a daily, weekly, monthly, quarterly basis.  Navigate payer portals and EMR reports.
   2. Works in collaboration with and build relationships with payer representatives with focus on Health Leaders Network
   3. Distributes reports, trends data, reports outcomes to management in a timely manner.  Always looking for ways to improve quality scores.
   4. Communicates expectations and deadlines that are attached to each report to the necessary team members that work the reports.  Provides graphs, charts or other written communication to display results.  Provides ongoing education to CCPs/LPNCCs on best practice and workflow.
   5. Closely monitors HLN gap closure needs by clinician and by clinic to assist with improving results.  Actively works at ways to improve and educate on HLN quality metrics.  Works closely with CCPs/LPNCCs to assist in working reports.
3. Management and Daily Operations
   1. Responsible for overseeing day-to-day operation of Quality Department.
   2. Trains staff and holds staff accountable to ensure that all quality audits are completed timely and in accordance with established guidelines.
   3. Coordinates and assists in developing and implementing new programs for clinicians and clinics.
   4. Promotes the quality and efficiency of his/her own performance by remaining current with the latest trends in field of expertise through participation in job-relevant seminars and workshops, attendance at professional conferences, and affiliations with national and state professional organizations.
   5. Participates in training new hires working as a CCP/ LPNCCs as well as the TCM process. Continue to train current incumbents as new initiative, best practices, and changes in healthcare occur.
4. Other Duties as Assigned
   1. Performs other duties as assigned or requested such as learning/assisting with Meaningful Use, MACRA, MIPS quality reporting.
   2. Completes other duties as assigned as requested by the organization.

Experience - 3 years in quality or performance improvement in a healthcare setting and one-year supervisory experience.
Education - Bachelor's Degree or ASN may substitute for Bachelor's if incumbent is a licensed RN
Special Skills - Demonstrated leadership skills including effective communication - both written and verbal. Strong computer skills including Word, Excel. Experience with timekeeping software. General knowledge of Medicare/Medicaid rules and regulations related to physician practices and billing practices Ability to lead and motivate a small workgroup Detailed and organized
Licensure - Ability to travel to various facilities within the health system