Quality Improvement Manager

5 - 7 years experience  •  Healthcare IT

Salary depends on experience
Posted on 11/10/17
Baton Rouge, LA
5 - 7 years experience
Healthcare IT
Salary depends on experience
Posted on 11/10/17

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely—56.7% in year-over-year revenue growth in 2016. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016 and 2017, and one of the “50 Great Places to Work” in 2017 by Washingtonian, and our CEO was number one on Glassdoor’s 2015 Highest-Rated CEOs for Small and Medium Companies. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

Who you will be working with:

Dedicated to a local market, the Quality Improvement Manager plays a key role with partner leadership in creating infrastructure required for accountability, quality improvement, and strategies for raising performance on national measures of population health management. The QI Manager operates under the direction of the Senior Director of Market Operations  with guidance from the Market Medical Director, and Evolent National Support Model leads. The QI Manager drives quality and value based care initiatives across regional primary care practices in an Accountable Care Organization. This role will be aligned to the Central Clinical Network and Performance team by participating in a large cohort of Population Health Manager’s and Quality Leads across the country to share, operationalize, and scale best practices across markets. 

What you will be doing:

The Quality Improvement (QI) Manager is responsible for (1) overseeing the execution management of quality improvement programs that meet CMS requirements; and (2) building relationships with physician practices to support physician engagement, clinical practice transformation and ensure Triple Aim achievement by conducting the key functions below:

  • Plays a critical role in performance improvement through the delivery and management of physician reports, providing feedback and education, and guiding actionable initiatives from data both as an individual contributor and through education of key market team members
  • Integrate care management, risk adjustment, annual wellness visit and quality initiatives into practice and assist with program engagement
  • Lead the transition of innovative ideas from pilot to implementation and share best practices across all markets
  • Co-facilitate and or lead practice manager forums/meetings related to value based care initiatives
  • Develop operational plans with direction from Market & Central leadership to successfully complete annual reporting requirements

Quality Improvement Program

  • Manage the implementation and successful completion of the ACO’s quality improvement program
  • Identify and prioritize key quality and utilization initiatives critical to client success under its performance based payment programs (e.g., achieving target thresholds for ACO Medicare Shared Savings Program, pay-for-performance contracts with national payers, etc.)
  • Support care gap closure through physician practices, nurse care manager/pharmacist interactions, and patient communications and education
  • Prepare and present reports and updates for internal and external client committees (e.g., ACO Quality Committee)


Population Health Management

  • Assist with network performance strategy, including, specialty referral strategies, co-management agreements, physician governance and infrastructure (PODs) and access initiatives
  • Total medical expense and cost savings initiative support
  • Strong relationship building by identifying influential physician leaders and leveraging practice relationships to engage, implement, and sustain Evolent programs
  • Provide EMR, Identifi Practice, and other technology training in the practice
  • Facilitate physician/practice education, managing execution of market based initiatives

The Experience You Need (Required):

  • Bachelor’s Degree or equivalent work experience
  • 5+ years of health care management experience with strong understanding of performance measurement and improvement processes
  • Preparing and analyzing quality data (ACO, payer, HEDIS, and CAHPS data)
  • A valid Driver's License and ability to travel locally/regionally up to 80% of the work day
  • Proficiency with Microsoft Office applications and data management reporting
  • Excellent written and oral presentation skills, with the ability to engage, inspire, build credibility and trust
  • Highly organized and self-motivated individual with ability to adapt to various work spaces and work autonomously
  • Collaborative working style with the ability to work across different teams, areas of expertise, and adapt to ambiguous environments and clientele
  • Hypothesis driven to identify trends, predict issues, highlight critical areas, and develop corrective action plans
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