PACE Quality Analyst I

at  San Ysidro Health

The PACE Quality Analyst I will be assigned to one of four SD PACE Center locations:

• San Ysidro PACE
• Chula Vista PACE
• El Cajon PACE
• Vista PACE

POSITION SUMMARY:

Under the supervision of the Quality Assurance Supervisor and lead by the Quality Manager, assists in all activities related to the SD PACE (Program of All-Inclusive Care for the Elderly) Quality Assurance and Performance Improvement (QAPI) Department. The QAPI Analyst will be responsible for collecting, documenting, tracking, and monitoring/managing data in accordance with CMS (federal) regulations, DHCS (state) regulations, accrediting body regulations and requirements, and San Diego PACE policies and procedures. In close coordination with QAPI and Operational Leadership, assists with the investigation and resolution of incidents, grievances, appeals, and potential quality of care concerns, as assigned in accordance with applicable state and federal regulations, compliance standards, and policies and procedures. The QAPI Analyst will assist in the annual review of the QAPI Work Plan, development, implementation, and monitoring of program-wide and center-specific performance measures, data management, education, and training of program staff around QAPI initiatives, preparation of routine and special reports, and coordination of improvement efforts arising from monitoring and/or audit activities.

Essential Functions of the Job:QAPI Analyst Job Functions:

• Collects and tracks real time data and provides feedback and guidance to the Interdisciplinary team (IDT) by participating in IDT meetings to ensure QAPI elements are documented in accordance with applicable state and federal regulations, compliance standards, and policies and procedures.
• Provides QAPI support to the IDT by guiding the IDT and Center Manager on recognizing and documenting elements of performance that are at risk of being out of compliance (i.e., Care Plans > 180 days).
• Gathers data from a variety of sources and organizes it into the correct format for analysis and interpretation.
• Collects, tracks, and monitors/manages all data for Level I reporting in order to enter it quarterly into the Health Plan Management System (HPMS).
• Analyzes SD PACE QAPI data and makes recommendations for improvement(s) when areas of opportunity are identified. Assists in developing new QAPI projects and then leads those projects using Plan-Do-Study-Act (PDSA) processes.
• Collaborates with various departments and stakeholders to assist in addressing potential QAPI issues.
• Analyzes and prepares data for QAPI presentations, as needed.
• Manages large data sets and organizes them into an interpretable format using the appropriate software tools.
• Assists in reporting to State and Federal regulators. Assists in putting together electronic files and documents for CMS quarterly calls and for CMS/State audits.
• Assists in putting together meeting materials, reports, and presentations, as assigned.
• Demonstrate experience in quality assurance and performance improvement activities.
• Reviews electronic health records for data collection, for investigation purposes and for medical records documentation quality checks.
• Assists in drafting and mailing letters related to notice of action (NOA), grievances, and appeals, as assigned.
• Maintains knowledge of policies and procedures and completes tasks in accordance with applicable regulatory requirements, external laws, and accreditation standards.
• In collaboration with the IDT Moderator, monitors and tracks grievances, complaints and dissatisfaction from participants to identify trends. Assists leadership in service recovery efforts.

EXPERIENCE REQUIRED (MINIMUM LEVEL OF EXPERIENCE):

• QAPI Analyst (I): 1-3 years of experience in working in quality or compliance in healthcare, preferably in Quality Improvement or compliance; familiarity with quality improvement processes. Preferably, 1-3 years of demonstrated experience in an analytical capacity, which includes the collection, organization, and reporting of data.
• QAPI Analyst (II): 3 or more years of experience in working in quality or compliance in healthcare, preferably in Quality Improvement or compliance; familiarity with quality improvement processes. 3 or more years of demonstrated experience in an analytical capacity, which includes the collection, organization, and reporting of data. Previous work experience as a PACE QAPI Analyst I.

VERBAL AND WRITTEN SKILLS REQUIRED TO PERFORM THE JOB:

• Excellent written and verbal communication skills with specific ability to maintain accurate records.
• Must have active listening ability and knowledge of adult learning modes required to train, facilitate, and motivate various staff in quality improvement activities.

TECHNICAL KNOWLEDGE AND SKILLS REQUIRED TO PERFORM THE JOB:

• Proficient in Microsoft Office Suite (Word, PowerPoint, Excel, Outlook, Visio) to present data in easily understood formats; advanced computer skills to learn specific applications.
• Meet a standardized set of competencies for the specific position description established by SD PACE and approved by CMS.

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

• Physical clearance for reaching, bending, stooping, crouching, kneeling and grasping; have full range of motion; ability to lift 50 lbs; need to lift and transfer participants; T.B. clearance; prolonged periods of sitting and standing.

UNIVERSAL REQUIREMENTS:

Pre employment requirements include I-9, physical, positive background and reference check results, complete application, new hire orientation, pre employment PPDs
About Us San Ysidro Health is a Federally Qualified Health Care organization committed to providing high quality, compassionate, accessible and affordable healthcare services for the entire family. The organization was founded by seven women in search of medical services for their families and community. Almost 50 years later, San Ysidro Health now provides innovative care to over 108,000 patients through a vast and integrated network of 47 program sites across the county. San Ysidro Health could not serve our patients without the dedication of our passionate and hardworking employees. Apply today and become a part of our mission-driven team! San Ysidro Health has a long-standing commitment to equal employment opportunity for all applicants for employment. Employment decisions including, but not limited to, those such as employee selection, performance evaluation, administration of benefits, working conditions, employee programs, transfers, position changes, training, disciplinary action, compensation, and separations are made without regard to race, color, religion (including religious dress and grooming), creed, national origin, nationality, citizenship status, domestic partnership status, ancestry, gender, affectional or sexual orientation, gender identity or expression, marital status, civil union status, family status, age, mental or physical disability (including AIDS or HIV-related status), atypical heredity cellular or blood trait of an individual, genetic information or refusal to submit to a genetic test or make available the results of a genetic test, military status, veteran status, or any other characteristic protected by applicable federal, state, or local laws

• Collects and tracks real time data and provides feedback and guidance to the Interdisciplinary team (IDT) by participating in IDT meetings to ensure QAPI elements are documented in accordance with applicable state and federal regulations, compliance standards, and policies and procedures.
• Provides QAPI support to the IDT by guiding the IDT and Center Manager on recognizing and documenting elements of performance that are at risk of being out of compliance (i.e., Care Plans > 180 days).
• Gathers data from a variety of sources and organizes it into the correct format for analysis and interpretation.
• Collects, tracks, and monitors/manages all data for Level I reporting in order to enter it quarterly into the Health Plan Management System (HPMS).
• Analyzes SD PACE QAPI data and makes recommendations for improvement(s) when areas of opportunity are identified. Assists in developing new QAPI projects and then leads those projects using Plan-Do-Study-Act (PDSA) processes.
• Collaborates with various departments and stakeholders to assist in addressing potential QAPI issues.
• Analyzes and prepares data for QAPI presentations, as needed.
• Manages large data sets and organizes them into an interpretable format using the appropriate software tools.
• Assists in reporting to State and Federal regulators. Assists in putting together electronic files and documents for CMS quarterly calls and for CMS/State audits.
• Assists in putting together meeting materials, reports, and presentations, as assigned.
• Demonstrate experience in quality assurance and performance improvement activities.
• Reviews electronic health records for data collection, for investigation purposes and for medical records documentation quality checks.
• Assists in drafting and mailing letters related to notice of action (NOA), grievances, and appeals, as assigned.
• Maintains knowledge of policies and procedures and completes tasks in accordance with applicable regulatory requirements, external laws, and accreditation standards.
• In collaboration with the IDT Moderator, monitors and tracks grievances, complaints and dissatisfaction from participants to identify trends. Assists leadership in service recovery efforts