About the RoleAre you looking to join a fast-growing, dynamic team?We're a collaborative, purpose-driven group that's passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients.
The Clinical Quality Advisor is responsible for directing and managing multi-departmental and cross-functional programs and projects, supporting quality improvement initiatives, analyzing performance data, and developing improvement activities based on industry best practices. This role focuses on the development and implementation of departmental or cross-functional team projects or initiatives, ensuring timely delivery and continuous improvements. The Clinical Quality Advisor interfaces with internal and external customers on technical matters and program status to enhance delivery and efficiency.
You will focus on:- Targeted Improvement Activities: Collaborate with team members to develop targeted improvement activities based on current outcome performance and industry best practices aimed at enhancing CMS Star Ratings, HEDIS, CAHPS, HOS, P4P, and other performance measures.
- Research and Integration: Research evidence-based practices, national and regional benchmarks, and industry standards, integrating findings into quality improvement initiatives to ensure alignment with best practices.
- Continuous Monitoring and Feedback: Perform ongoing monitoring of improvement activities through routine analysis of measure outcomes, providing meaningful and actionable feedback to management regarding process enhancement.
- Performance Improvement Methodologies: Effectively utilize and implement performance improvement methodologies to support internal quality initiatives, focusing on rapid-cycle performance improvement for timely and effective results.
- Quality Improvement Program Maintenance: Participate in the development and maintenance of annual quality improvement program documents and evaluations, ensuring the accuracy and relevance of information.
- Training and Development: Support the development, upgrade, and delivery of comprehensive quality improvement training programs and problem-solving methodologies/tools for quality improvement teams and other stakeholders, fostering a culture of continuous improvement.
- Support Intradepartmental Teams: Actively support intradepartmental quality improvement teams, programs, projects, and initiatives, ensuring alignment with organizational goals and objectives.
- Technological Advancement: Continuously seek opportunities to enhance the delivery and efficiency of external-facing quality improvement initiatives through technological advancements and internal process improvements.
- Data Translation and Recommendations: Translate complex data into meaningful information, draw conclusions, and relate findings to industry standards. Provide informed recommendations to departmental stakeholders and the Quality Improvement Leadership Team regarding performance gaps, program implementation, and performance outcomes.
- Report Preparation and Data Analysis: Prepare comprehensive reports, conduct detailed data analysis, and create other materials for presentation to committees and management, ensuring clear communication of findings and recommendations.
- Program and Process Improvements: Actively contribute to the continuous improvement of programs and processes, setting and achieving operational targets within the job area and recommending system/process enhancements to solve problems or improve effectiveness.
- Program Monitoring and Continuous Improvement: Monitor programs from initiation through delivery, ensuring continuous improvement. Organize interdepartmental activities to ensure completion within schedule and budget.
- Governance and Milestone Tracking: Represent the program in project governance and inter-departmental forums. Define and track program milestones while developing, maintaining, and reporting on an integrated delivery plan, while adhering to methodology compliance standards set by the company.
- Operational Targets and Problem Solving: Achieve operational targets with direct impact on departmental results. Independently manage projects under limited supervision, and work to improve processes, systems, or products to enhance job area performance.
- Complex Problem Solving: Solve complex problems involving multiple issues or specialties by drawing on prior experience and analysis. Develop new perspectives and approaches to existing problems.
- Communication and Influence: Communicate with internal and external parties to provide and obtain information. Influence parties within and outside of the job function at an operational level regarding policies, practices, and procedures. Provide guidance, coaching, and training to other employees and manage projects, delegating and reviewing work as needed. Serve as a subject matter expert, regularly briefing key stakeholders on initiatives.
- Committee Participation and Leadership: Lead and actively participate in multi-departmental and cross-functional committees and external stakeholder workgroups, to support key quality improvement initiatives.
- Audit Participation and Process Improvement: Participate in audits as required and contribute to the development and implementation of corrective processes to meet audit requirements and enhance clinical performance, quality, and care management.
The Skills, Experience & Education You Bring- Bachelor's degree or equivalent experience
- Minimum 8 years of prior relevant experience in managed care quality improvement, care management or clinical program management in a clinical/healthcare environment
- Managed Service Organization (MSO)/Independent Practice Association (IPA) or Health Plan population health management or quality experience
- Working knowledge of HEDIS, CAHPS, HOS, CMS Medicare Star Ratings, P4P programs, CMS quality withhold, Managed Care Accountability Set (MCAS) and NCQA Quality Improvement standards
- Specific licensing requirements may apply (e.g., LVN, RN, NP, PA, MSW, CPhT)
The Compensation for this position is
$107,00 - $128,500/yearIn addition, we provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.
- Excellent medical, vision, and dental coverage
- 401k savings plan with a company match
- Flexible time off and 9 Paid Holidays
