Quality - Quality Manager (on-site)

The Quality Manager is responsible for leading the organization's quality improvement activities to ensure measurable improvement in clinical quality, preventive care, and grant-required performance measures. This role oversees performance monitoring and improvement initiatives related to HEDIS, GPRA, HRSA, and grant-specific measures, and is accountable for driving sustained improvement through workflow redesign, data analysis, patient outreach strategies, and cross-functional collaboration.

The Quality Manager works closely with clinical, operational, care management, outreach, and grants teams to identify gaps in performance, implement corrective actions, and ensure improvement is documented, measurable, and sustainable.

This position focuses on systems improvement and performance outcomes, not direct clinical care. Must be able to demonstrate knowledge and skills necessary to perform all job-related activities as outlined below. In addition, must perform other duties as assigned.

Essential Duties and Responsibilities:

Primary Functions:

Quality Measurement & Performance Oversight

1. Oversees tracking, monitoring, and reporting of quality measures, including but not limited to:
   1. HEDIS measures.
   2. GPRA measures.
   3. HRSA clinical quality measures.
   4. Grant-specific performance indicators.
2. Reviews performance data regularly to identify gaps, trends, and improvement opportunities.

1. Ensures quality measures are calculated, validated, and reported accurately and timely.
2. Maintains dashboards and reports for leadership, clinical teams, and grant stakeholders.

Workflow Analysis & Process Improvement

1. Leads analysis of clinical and operational workflows impacting quality outcomes.
2. Identifies breakdowns in processes related to screening, follow-up, documentation, and patient engagement.
3. Designs and implements workflow changes to improve performance and close care gaps.
4. Ensures workflow changes are standardized, documented, and scalable across sites or departments.
5. Monitors post-implementation results to ensure improvements are sustained and measurable.

Patient Outreach & Gap Closure Strategies

1. Partners with non-clinical patient outreach efforts to improve quality measure performance, including:
   1. Outreach calls, reminders, and follow-up coordination.
   2. Appointment scheduling support.
   3. Referral follow-up tracking.
2. Develop protocols for patient contact when outreach is needed to close care gaps.

1. Works with PSRs, care coordinators, CHWs, and other teams to ensure outreach activities align with quality goals.
2. Monitors outreach effectiveness and adjust strategies based on results.

Cross-Department Collaboration & Accountability

1. Partners with clinical leadership, care management, PSR, referrals, IT, and grants teams to drive quality improvement.
2. Aligns quality initiatives with grant requirements and funding objectives.
3. Coordinates with Grants and Finance teams to ensure quality performance supports grant sustainability.
4. Brings data-driven recommendations to leadership to address underperforming measures.
5. Ensures accountability across teams contributing to quality outcomes.

Gant & Program Quality Support

1. Supports grant-funded programs by aligning workflows and activities with required performance measures.
2. Monitors quality-related grant deliverables and timelines.
3. Provides documentation and evidence of improvement for grant reporting, audits, and site visits.
4. Works with program managers to remediate underperforming measures that may impact funding.

Training, Guidance & Change Management

1. Provides training and guidance to staff on quality workflows, documentation standards, and measure requirements.
2. Translates complex measure definitions into practical operational steps for staff.
3. Supports change management efforts to ensure adoption of new workflows.
4. Reinforces the importance of quality improvement as a shared organizational responsibility.

Compliance, Documentation & Audit Readiness

1. Ensures quality improvement activities are well-documented and audit ready.
2. Maintains policies, procedures, and QI plans related to quality management.
3. Supports internal and external audits, site visits, and monitoring activities.
4. Ensures quality improvement efforts align with regulatory and grant requirements. Quality and patient safety to adopt best practices.

Qualifications:

Minimum Qualifications:

1. Bachelor's degree from an accredited college or university in Nursing, Quality, Social Work, or other health related field preferred.
2. Minimum 3-5 years' experience in healthcare quality improvement, population health, or performance management.
3. Some knowledge of Clinical Compliance, Best Practices, Medical Record Review, Legal Aspects of Documentation, or medical coding and billing preferred.

Preferred:

1. Experience in Compliance, Risk Management, Quality Management, Documentation Standards, Billing, and Coding knowledge.
2. Experience serving a multinational, multicultural population.
3. FQHC background.

1. Familiarity with Community Health Clinics and/or Indian Health Clinics.

1. ECW EHR.

Special Conditions of Employment:

1. CPR/ BLS certification: Maintain a current Basic Life Support (BLS) certification issued by the American Heart Association (AHA), the American Red Cross, or an equivalent organization. Certification must include an in-person, hands-on skills assessment. Online-only certifications are not accepted.
2. Annual background checks: Consent to annual background checks as a condition of continued employment, to ensure compliance with organizational standards and eligibility requirements.
3. For-Cause Drug Screening: Comply with drug screening requirements when initiated by the organization for cause, to support a safe, compliant, and drug-free workplace.
4. Ongoing Compliance Requirements: Maintain up-to-date compliance with all required annual renewals, including professional licenses, certifications, physical examinations, TB testing, and mandatory regulatory trainings as assigned by the San Diego Community Health Center (SDCHC).
5. As a dually funded organization, the Health Center reserves the right to assign, modify, or remove this position's funding allocation to or from any applicable grant or funding source at any time, based on organizational needs, funding availability, and grant requirements

Knowledge, Skills, and Abilities:

1. Attention to detail development and maintenance of regulatory paperwork.
2. Ability to work independently, as well as to be part of a collaborative team.
3. Strong presentation skills and ability to create needed educational materials.
4. Excellent written and oral communication skills.
5. Computer competence, highly effective collaboration, written and verbal communications skills.
6. Attention to detail development and maintenance of regulatory paperwork.
7. Excellent oral and written communication skills.
8. Computer proficiency, including programs such as MS Office, Word, Excel, email, and internet research, required.
9. Must possess the ability to educate and train Compliance and Clinical standards to staff members.
10. Excellent time management skills
11. Excellent organizational skills and attention to detail.
12. Ability to maintain confidentiality and meticulous records.
13. Effective interpersonal skills.
14. Able to deal effectively with a diversity of individuals.
15. Ability to establish and maintain cooperative working relationships with all during the course of work.
16. Able to perform basic mathematical calculations necessary to perform the job function.
17. Must be reliable and extremely trustworthy.
18. Demonstrated proficiency in Microsoft Suite or related programs.

Physical and Mental Requirements:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without accommodation.

1. Able to lift/move up to 10 pounds, move from place to place.
2. Able to sit at a desk and work on a computer for prolonged periods.
3. Able to stand, bend and reach for prolonged periods.
4. Ability to do math, organize and prioritize workload, work effectively and efficiently under stress.
5. Ability to supervise, multitask, understand, and follow instructions.
6. Ability to proficiently read, write, speak, and understand English.

Customer Service:

1. Actively supports, promotes, and works to fulfill the Mission, Vision, and core values of SDCHC.
2. Provides excellent internal and external customer service.
3. Demonstrates SDCHC's Standards of Customer Service Behavior: Compassion, Attitude, Communication, Appearance, Sense of Ownership, and Teamwork.
4. Participates in on-going customer service training.
5. In every action, seeks to promote SDCHC as a top service organization.

Quality Management:

1. Contribute to the success of the organization by participating in quality improvement activities.
2. Complies with all SDCHC policies and procedures and proactively participates in the implementation of new initiatives.
3. Participate and ensures continuous quality improvement process as directed by clinic leadership.

Safety:

1. Ensures regulatory compliance and adherence with policies and procedures related to safe work practices.
2. Participate in infection prevention through appropriate use of infection control measures during patient treatment and patient interactions.
3. Ensure compliance with regulatory requirements for maintaining physical spaces, equipment, and supplies.
4. Uses all appropriate equipment and/or tools to ensure workplace safety.
5. Immediately reports unsafe working conditions.

Privacy/Compliance:

1. Maintains privacy and security of all patients, employee, and volunteer information and access to such information. Such information is accessed on a need-to-know basis for business purposes only.
2. Complies with all regulations regarding corporate integrity and security obligations. Reports unethical, fraudulent, or unlawful behavior or activity.
3. Upholds strict ethical standards.

Flexibility: Available for all shifts and, when required, able to work evenings and weekends

Disclaimer

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. This description reflects management's assignment of essential functions. It does not prescribe or restrict the tasks that may be assigned. This job description is subject to change at any time.