Manager of HEDIS

AboutPriority Health

We arethe second largest and fastest growing health plan in Michigan focused on improving the health and lives across the state, and we couldn't do it without the incredible talent of our employees. It is their commitment that continues to drive our success as a nationally recognized nonprofit health benefits company. As part oftheCorewell Health system, our team members have a unique ability to grow and advance their career while maintaining their seniority and benefits.

Scope of Work

This role will directly support current HEDIS operations as well as the emerging and critical new work associated with the Priority Health's Stars and Quality Programs. This role will be responsible for daily HEDIs operations tied to retrospective HEDIS and rates submissions to NCQA. Additionally, this role will support new work associated with Priority Health's company growth and expansion. Manages the Quality and Senior Quality Improvement Specialists and their work. Responsible for the creation, implementation, and management of the Quality Department projects and the formation of clinical improvement teams. This work includes the assessment, analysis, planning, implementation and evaluation of a large number of interventions, programs and data. Additionally, the role includes consultation within the health system in planning group processes, targeting improvement strategy initiatives and for facilitating change through internal team building.

Essential Functions

• Supports quality improvement activities with annual project plans outlining measurable deliverables and quarterly milestones, ensuring services are provided in accordance with state and Federal regulations, organizational policy and procedures, medical staff by-laws, and accreditation / compliance requirements.

• Expertise in leading team activities in a manner that is organized but fosters creative thinking and activity. Identifies and monitors project scope, target timelines, resource requirements, cost, milestones, data requirements and completes documents and reports as necessary.

• Manages the work priorities of the Quality Improvement Department on high volume, high cost, and high-risk projects. Delegates the general work assignment areas for all employees and assigns special projects individually. Mentors, coaches and develops employees while being a role model and resource to them.

• Responsible for interviewing, hiring, retaining employees and members of the team, monitoring performance monitoring. Initiating when appropriate, follow through with disciplinary action and termination in consultation with Human Resources for service. Mentors, coaches and develops employees and developing Smart Objectives.

• Expert in communicating team results on a routine basis to management and key players in a timely and complete manner. Maintains knowledge of team activities and keeps strict confidentiality as appropriate. Has expertise in process improvement theory and strategies, data analysis and change theories. Shares key learnings with others and fosters direct and honest communication.

• Manage and coordinate the development and implementation of patient safety culture behaviors and initiatives within the physician clinical practice.

• Networks with peers in the field and ensures that all services are provided in a manner consistent with state and Federal regulation, organizational policy, accreditation, and/or compliance. Knows and support key organizational strategies and incorporates them into team strategies. Maintains knowledge of current trends and developments in the field by reading appropriate books, journals, and other literature and attending related conferences, seminars, etc.

Qualifications

• Bachelor's Degree or equivalent, in health care, engineering, case management, business administration. Required

• Master's Degree or equivalent. Preferred

• 7 years of relevant experience skills, knowledge, abilities typically gained through 7 years of related health care, business, or quality improvement experience. Required

• 3 years of relevant experience leading others. Required

• Experience with multidisciplinary teams in a complex healthcare system. Preferred

• At least one Certification - Institute for Healthcare Improvement (IHI). preferred

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

• Optional identity theft protection, home and auto insurance, pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

Primary Location

Department Name

Employment Type

Shift

Weekly Scheduled Hours

Hours of Work

Days Worked

Weekend Frequency

CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.