Dignity Health Clinical Quality Manager in REDLANDS, California
The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
This position performs clinical administrative support to the Quality Management Department. Responsibilities include chart audit and data gathering and reporting of quality measures and identifying clinical and educational needs.
JOB KNOWLEDGE, SKILLS & ABILITIES
Knowledge and understanding of medical management.
Knowledge and experience using TQM/CQI processes a plus.
Ability to read and comprehend documents of a moderately complicated nature.
Able to understand and apply the appropriate specifications for numerator and denominator, and exclusion criteria for quality measures
Strong problem-solving abilities. Ability to identify issues and problems within clinical and administrative activities.
Must be attentive to detail, accurate, thorough, and persistent in following tasks through to completion.
Excellent communication skills with all levels of internal/external staff, management, members, physicians/physician office staff, vendors, etc.
Ability to call patients for clinical follow-up and to aid in their access to care (Spanish is a plus).
Ability to handle various situations in a professional manner, demonstrating excellent customer service at all times and ability to adapt to change.
Ability to effectively provide feedback to team members through written and verbal communication.
EDUCATION & EXPERIENCE
Current California RN or LVN license required.
Three or more years’ experience in outpatient clinical care, preferably in a medical management environment.
Prior knowledge of quality measurements (HEDIS, Pay for Performance, PQRS, etc.) and experience using the scores to improve care.
Knowledge of QNXT, NextGen or similar programs is preferred.
Must have valid California drivers’ license and clean DMV record.
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Job ID 2018-54485
Employment Type Full Time
Department Quality Management
Hours / Pay Period 80
Facility Dignity Health Management Services Organization
Standard Hours Mon-Fri (8-5 PM)