Job Summary
This position is located within the Department of Health Care Finance (DHCF), Health Care Delivery Management Administration (HCDMA), Division of Quality and Health Outcomes. This position has responsibility for ensuring quality and performance improvement principles and practices pervade all the components and activities that impact on the delivery and outcomes of healthcare services to patients served by the District's Medicaid, CHIP and Fee for Service programs.
Duties and Responsibilities
Plans, develops, implements, manages, and evaluates health plan or provider monitoring to assess compliance with structural and operational quality standards, with a particular focus on long-term services and supports (LTSS) received in both institutional and community settings. Assures that provider or health plan quality requirements are met, and that provider or health plan performance meets Medicaid standards. Develops, manages, and evaluates short term and long-range initiatives to measure and improve the quality of health services delivered through DHCF programs. Develops quality measurement and improvement initiatives in collaboration with organizational units within DHCF responsible for supporting and/or administering certain programs areas. These may include programs for families and children, acute programs, program integrity, and policy and research. Collaborates with other District agencies responsible for caring for these populations as well as organizations providing health care services, advocacy organizations, and other interested parties.
Analyzes and recommends changes to improve quality measurement and/or improvement projects, protocols, strategies, and initiatives proposed, planned, or undertaken by health care providers, contractors to DHCF, or other parties. Plans, develops, implements, manages, or evaluates studies on health care quality that are focused on particular aspects of clinical and non-clinical services. This may include use of contractors to perform activities such as the, assessment of quality assessment and performance improvement projects, and the conduct and analysis of consumer and/or provider surveys. Develops statistical and narrative reports of health plan and provider progress towards improving quality and recommends actions to be taken to improve quality, where appropriate. Monitors reports of events that threaten patient safety. Assesses and evaluates reports in order to elicit an appropriate and timely response from relevant District agencies.
Qualifications and Education
Specialized Experience Experience that equipped the applicant with the particular knowledge, skills and abilities to perform successfully the duties of the position, and this is typically in or related to the work of the position to be filled. To be creditable, at least one (1) year of specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression.
Licenses and Certifications
None
Working Conditions/Environment
The work is performed in an adequately lighted, heated, and ventilated office environment
Other Significant Facts
Tour of Duty: Monday-Friday; 8:15AM - 4:45PM
Pay Plan, Series and Grade: CS-0343-13
Promotion Potential: No known promotion potential
Collective Bargaining Unit (Union): This position is represented by a collective bargaining unit and is subject to union dues thru payroll deduction.
Residency Requirement: Applicants claiming Residency Preference will be required to maintain residency in the District of Columbia for a minimum of seven (7) years. Failure to do so may result in forfeiture of employment.
Position Designation: The position has been deemed security sensitive. Accordingly, the incumbent will be subject to pre-employment checks (criminal background checks, consumer credit check, traffic record checks, if applicable) as a condition of employment, and will be subject to periodic criminal background checks for the duration of your tenure.
