Hedis Clinical Quality Program Manager Jobs (NOW HIRING)

Shift Days, Salaried Scheduled Weekly Hours 40

Responsible for managing and coordinating all aspects of regulatory programs (i.e., Quality Payment Program, Hospital Promoting Interoperability) including performance monitoring, data submission and quality improvement initiatives. Serves as an internal resource and external liaison to software vendors with EHR quality data and regulatory programs.

• Point person facilitating the collaboration between the application owners and operational stakeholders to gather requirements and lead project teams through required build needs based on quality measures and regulatory requirements.
• Review measures to stay up to date with the new requirements for CMS regulations and validate that the Epic build and current workflows meet the requirements of measure specifications.
• Centralization of report development, production, and distribution of metrics to meet Promoting Interoperability attestation requirements.
• Communicate issues with Electronic Medical Records (EMR) applications that affects Promoting Interoperability Program performance.
• Coordinate activities to maintain public health registry engagement.
• Effectively communicate reporting expectations to stakeholders in a timely and clear manner.
• Estimate the resources and participants needed to achieve reporting goals.
• Plan, schedule, and track reporting timeline, milestones, and deliverables using appropriate tools.
• Proactively manage changes in reporting scope, identify potential issues, and devise contingency plans.
• Monitors progress and reporting on regulatory program outcomes.
• Update and integrate Medicare Reimbursement Regulatory (e.g., QPP, Hospital PI, 21st Century Cures Act, HTI-1, CPGs, etc.) guidelines into program strategies, ensuring adherence throughout the organization.
• Lead software and clinical informatics projects related to federal and state required data collection, including but not limited to electronic Clinical Quality Measures (eCQM), Clinical Quality Measure/Core Measure, HEDIS, and required State reported data.
• Collect, analyze, interpret, and report data related to healthcare provider performance, quality, and healthcare performance data utilizing expertise in data science and healthcare reporting.
• Collaborate with cross-functional teams to develop and refine performance metrics, ensuring accuracy and integrity in the evaluation processes.
• Drive continuous improvement initiatives based on data analysis and communicate findings to both technical and non-technical stakeholders.
• Serve as liaison for regulatory bodies such as the State Department of Public Health, Centers for Medicare and Medicaid Services (CMS), and Joint Commission regarding data requirements and submissions.
• Create dashboards and reports to effectively communicate data analysis results to business leaders.

Bachelor’s degree in business management, computer science, information technology, healthcare, or a closely related field Three (3) years of professional level experience in working with systems with demonstrated project management experience or managing complex EHR implementation and optimization projects, or progressive project and process management experience. Master’s degree in healthcare related field or business required within three years of hire. Excellent organizational, oral, and written communication skills, problem solving, program development, computer skills, strong leadership, and team building skills. Ability to work with a variety of disciplines and levels of staff across departments and present information clearly and concisely is required. Excellent analytical skills, with the ability to collect and interpret data, identify trends, and make evidence-based recommendations. Problem-solving and critical thinking abilities to identify issues, root causes, and innovative solutions. Ability to manage multiple priorities, projects, and deadlines effectively.

$75,920.00 - $113,880.00

• Health and Dental Insurance
• IMRF (Illinois Municipal Retirement Fund) Retirement Fund (457 and 401A Plan)
• Medical and Dependent Care Flexible Spending
• Life Insurance
• Short and Long Term Disability
• Optional Insurances
• Paid Time Off
• Tuition Reimbursement and Loan Forgiveness
• Gift Shop Discount
• CGH Day Care Discount
• CGH Dietary Discount
• Employee Assistance Program
• CGH Pharmacy Discount
• CGH Vision Center Discount

Thank you for your interest in a career at CGH Medical Center. Extraordinary care. Extraordinary service. Extraordinary people.

Since 1909, CGH Medical Center has been serving Sterling, Rock Falls and the surrounding communities with exceptional quality healthcare. Through the years, there’s been one constant, the passion of our employees for making a difference. As part of CGH, you’ll join a team that’s focused on delivering the best health care and patient experience for all of the communities we serve. From our hospital and Main Clinic to our 16 outlying clinics, our physicians and employees are dedicated to providing high-quality healthcare to our patients, friends and family with outstanding skill and heartfelt compassion. Are you ready to develop, grow, and advance your career in healthcare? Then explore our careers today and get ready to join the team at CGH Medical.