Overview

Department Overview

Our subsidiary is responsible for coordinating care for healthy eligible individuals, those with multiple chronic conditions, pregnant women, and men and women needing family planning. The goal of the program is to ensure an effective and efficient delivery of care. This area works with low income populations to improve the quality of care programs and community outreach.

Primary Responsibilities

The Quality Care Director is responsible for overseeing Population Health Management strategies under the ACHN program. This position works closely with the Population Health Data Analyst, Medical Director and Care Coordination team to identify high risk recipients for care coordination activities. This position is responsible for monitoring the quality effectives of all interventions provided to recipients in the program. These activities will include outreach to participating providers and presentations to the Medicaid Agency. Outcomes of these quality projects are tied to financial withholds. Successfully meeting benchmarks will enable My Care to earn additional revenue and fulfill contract requirements.

Summary of Qualifications

• Bachelor's degree in public health, public administration or healthcare quality and safety.
• Master's degree is Preferred: Relevant work experience can be substituted
• Certified Professional in Healthcare Quality (CPHQ) or equivalent experience related to healthcare quality
• Prior experience, at least one year, working with Medicaid populations
• Familiarity with Healthcare Effectiveness Data and Information Set (HEDIS), CAHPS, and other standardized quality measures/assessments
• Proficiency in quantitative data analysis
• At least 3 years' experience related to population health management, including interpretation and presentation of data; identifying opportunities for improvement; and developing strategic plans to address quality deficits
• Must live in the designated region per contract requirements.
• Knowledge of Alabama Medicaid regulations and guidelines is preferred

Terms and Agreements

By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews.