Quality Manager at Wellvana

Nashville, Tennessee, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Apr, 26

Salary

0.0

Posted On

20 Jan, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Time Management, Organizational Skills, CMS Program Requirements, Quality Improvement, Data Optimization, Performance Enablement, Educational Content Development, Care Coordination, Clinical Documentation, Technical Requirements Interpretation, Partner Engagement, Workflow Development, Reporting, Continuous Improvement, Healthcare Experience, Communication

Industry

Hospitals and Health Care

Description

Description The Why Behind Wellvana: Description The healthcare system isn’t designed for health. We’re designed to change that. We’re Wellvana, and we help doctors deliver life-changing healthcare. Through our elevated value-based care programs, we’re revitalizing an antiquated system that’s far too long relied on misaligned incentives that reward quantity of care not the quality of it. Our enlightened approach—covering everything from care coordination to clinical documentation education to marketing— ties the healthy outcomes of patients directly to shared savings for primary care providers, health systems and payors. Providers in our curated network keep their independence, reduce their administrative headaches, and spend more time with patients. Patients, in turn, get an elevated experience with coordinated care between appointments that is nothing short of life-changing. Named a 2024 "Best in Business" and 2023 "Best Place to Work" by Nashville Business Journal, we’re one of the fastest-growing healthcare companies in America because what we do works. This is the way medicine is meant to be. Clarity on the Role: Quality Managers require a deep understanding of CMS measure technical specifications and previous quality experience. These qualifications will ensure that the Quality Strategy is implemented and continued as designed. The Quality Manager will be the main point person for not only the Partner Success team but partners for each designated region, ensuring even workload split and continuity with partners. The Quality Manager will be responsible for the following: Obtain and analyze the baseline assessment of clinical and EHR workflows of each assigned partner Work with partners as needed to further develop workflows and ensure documentation meets unique reporting requirements Ensure partners are knowledgeable with the Wellvana Universal Measure Set and how that differs from their end-of-year reporting requirements Monitor performance monthly through a standard reporting package, develop actionable next steps for discussion with partners for continuous improvement Data Optimization Performance Enablement Deliver and assist with interpretation of technical requirements needed for each program to ensure optimal performance Ensure supplemental data is uploaded to payor portals as applicable Deliver strategies that utilize established industry best practices and clinical pathways to meet and exceed measure benchmarks through utilization of multiple educational platforms and techniques Webinars Educational Content Development (e.g. Quality Measure guidebook) 1:1 educational support Ongoing education of the Partner Success Team and Growth team around annual metric changes to ensure successful engagement of both internal and external clients around quality programs Partner with internal teams to successfully deploy ACO REACH/PC FLEX data reporting (previously HEDR) Special projects as assigned (e.g. MIPS for Prospective Partners) Attend JOCs, monthly quality calls, and monthly action planning meetings as appropriate Collaborate with external vendor to ensure end of year quality reporting is evaluated and submitted based on based overall score for each ACO Requirements Integrity: The right way is the only way Dependability: You do what you say you’re going to do Advocacy: You fight for the best possible outcome for providers and their patients Clarity: You make it all understandable Education: Bachelor’s degree in a related field and/or the equivalent combination of training, education, and experience, required Years of Related Experience: 3-5 years in a healthcare related field Skills: Strong time management and organizational skills. Able to meet assigned deadlines. Knowledge of CMS program requirements for each line of business - ACO, MSSP and Medicare Advantage Nashville candidates preferred

Responsibilities

The Quality Manager will analyze clinical and EHR workflows of assigned partners and ensure documentation meets reporting requirements. They will monitor performance, develop actionable strategies for improvement, and provide ongoing education to internal teams and partners.