Manager Title: Director of Performance Improvement
FLSA Status: Non-Exempt
Job Summary:Actively improve the overall quality, efficiency and value of services provided at PCC Community Wellness Center through ongoing performance improvement activities. Create reports, manipulate and synthesize data, and monitor clinical quality data to meet internal and external requirements and improve key organizational outcomes.
Essential Duties and Responsibilities:
Synthesize, monitor and track pay-for-quality data from insurance carriers, including Harmony, Aetna, BCBS, United Health Care, Molina, Illini Care, Chicago Health Systems, Century PHO, Medical Home Network and Family Health Network.
Analyze pay-for-quality data for inconsistencies via EMR and billing audits, summarize findings, and prepare reports to share internally and to outside organizations.
Participate in ongoing collaborations with health insurance plans to ensure accuracy and timeliness of data and reports.
Regularly collaborate with the Care Coordination Department to close gaps in care and maximize outreach efforts.
Generate patient satisfaction survey reports for all sites; create quarterly summaries/infographics using patient satisfaction survey data collected.
Track and monitor Meaningful Use Quality reports for PCC Providers; complete MU attestation forms and assist with attestation process as needed.
Track and monitor Performance Metrics for PCC Providers; provide Medical Director of Performance Improvement with quarterly and annual reports.
Create and generate quarterly and annual Provider Quality Improvement Reports.
Responsible for the collection and submission of documents required for PCMH certification/recognition. Create, validate, and monitor PCMH reports and conduct all PCMH audits.
Track and monitor Peer Review process for all PCC Providers; create and run quarterly reports.
Participate in the Reports Committee; develop reports for various departments, programs, and grants at PCC.
Validate UDS quality reports and calculate annual results for quality measures; assist with other UDS data manipulation and analysis as needed.
Monitor all incoming HEDIS requests and submit appropriate documentation in a timely manner.
Recommend and implement solutions for existing processes; participate in planning, development, and evaluation of solutions and processes.
Utilize data to validate and create reports and perform analysis as needed.
Collaborate closely with PCC Providers, other internal staff and external organizations.
Receive direction and guidance on an ongoing basis from Director of Performance Improvement
Perform other duties as required and assigned.
Associates Degree required.
Bachelor’s Degree in related field preferred.
2 - 3 years’ experience in reporting and data management required.
Proficient in MS Office Business Applications to include: Outlook, Word, PowerPoint, and Excel.
Must be able to remain in a stationary position 50% of the time.
Must be able to move around the clinic site 50% of the time.
Constantly operates a computer, computer printer, copy machine, and telephone.
Occasionally positions self to maintain exertion of physical strength to move objects of 10 pounds from one level to another.
Must be able to transport from one site to another.
Must be able to cover other shifts as necessary.
Ability to read and write proficiently using the English language.
Constantly communicates with other healthcare providers. Must be able to exchange accurate information in these situations.
Follow-through, assume responsibility and use good judgment.
Maintain professionalism under stressful situations.
Self-motivated and directed with the ability to prioritize and work efficiently under pressure.
Ability to understand and follow verbal and written communication.
Detail oriented with the ability to work with minimal/no supervision.
Willingness to be part of a team-unit and cooperate in the accomplishment of departmental goals and objectives.
Effective and creative problem solving.
Additional Salary Information: Commensurate with applicable experience, starting hourly rate of pay: $16.31.
The mission of PCC is to improve health outcomes for the medically underserved community through the provision of high quality, affordable, and accessible primary health care and support services. Anchored with family medicine, we are committed to serving the needs of all people in all stages of life, while we continue to specialize in the delivery of comprehensive maternal and child health servic...es to address this unmet need in our community.
PCC prides itself in providing a model work environment. PCC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.
For more information on PCC Community Wellness, please visit our Web site at http://www.pccwellness.org