Senior Quality Improvement/Assurance Analyst

POSITION SUMMARY

The Senior Quality Improvement/Assurance Analyst will play a crucial role in supporting initiatives related to continuous quality improvement and maintain the quality assurance program. This position works with the Senior Quality Immunizations Program Analyst, Senior Quality Data Analyst, the Quality Improvement Manager and Safety and Clinical Risk Manager

EXPECTATIONS

Every Adelante Healthcare employee will strive to maximize their performance and contribution to Adelante Healthcare and the community we serve every day.  Employees are expected to work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation, and the highest standards of personal integrity, professionalism, and competence.

OUR CORE VALUES

• Inclusion
• Nurture
• Service
• Purposeful
• Integrity
• Resilient
• Engaged

ESSENTIAL SKILLS AND EXPERIENCE:

• High School Diploma or equivalent

• Graduation from an accredited medical assistant program and Medical Assistant Certification required
• Five (5) years’ experience as a Medical Assistant in health care setting.

• Knowledge of regulatory agency requirements including Joint Commission, HRSA, OSHA, and AZDHS
• Excellent problem-solving skills and attention to detail
• Ability to maintain confidentiality, privacy, and security of protected information
• Ability to draft analytic reports integrating multiple data elements and perspectives 
• Excellent working knowledge of Microsoft Office Applications including Outlook, Word, PPT, Excel, Teams, and SharePoint 
• Knowledge of SBAR, CQI, RCA, ACA, Process Mapping, and PDSA methodology    
• Ability to travel to health center locations  
• Successful completion of NAHQ Foundational: HQ Principles or completion within 6 months of hire   
• Certification to perform cardiopulmonary Resuscitation for the Health Care Professional (CPR) and AED through courses that follow the guidelines from the American Heart Association and Red Cross (cognitive and skills evaluations)

• Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations
• Comply with the organization’s immunization requirements
• Valid Arizona driver’s license and automobile insurance

POSITION REPONSIBILITIES

Quality Improvement

Uniform Data System

• Navigate the Health Resources & Services Administration website to update UDS new targets and specs
• Utilize AZARA platform to Identify quality metrics targets that have been achieved or have opportunities for improvement

• Identify missing documentation, validation or evidence of target completion

• Designate targets achieved by health center, providers and organization
• Develop and implement Quality Improvement plans

Health Effectiveness Data Information System

• Utilize networks’ portals platform to:

• Identify quality metrics rates by payor
• Identify missing documentation, orders, or other supportive documentation to close the care gap.
• Attend Value-Based Care Quality Improvement meetings to develop and implement quality improvement plans to Improve patient care outcomes, decrease medical cost and increase revenue

Collaborate with Quality Improvement Manager to:

• Develop power point presentations to open awareness on Uniform Data System (UDS) metrics & Health Effectiveness Data Information (HEDIS) quality metrics among the organization and to share progress in our Quality Committee meeting

• Develop and implement Continues Quality Improvement Plans by utilizing PDSA (Plan, Do, Study, Act) methodology
• Collaborate with health centers to shadow clinical staff to observe workflow process to improve UDS quality metrics and patient outcomes
• Conduct gap analysis based on observations of Medical Assistants’ workflows to improve patient outcomes
• Collaborate with the training department to update workflows as needed
• Conduct quality metrics process mapping to identify areas of improvement in collaboration with SQIDA
• Collaborate with Quality Improvement Manager to create, review progress and update completion of quarterly and annual goals.
• Ensure Goals set up for Quality Improvement Plans, Annual/Quarterly goals, Continues Quality Improvement plan meet the SMART (Specific, Measurable, Attainable, Realistic, Time-bound) criteria

Clinical Audits

Conducts clinical audits to identify:

• Potential risks regarding the quality and safety of patient care
• Compliance with regulatory requirements, AHC policies and procedures, and healthcare standards of care including but not limited to:
  • Informed Consents
  • Deceased Patients
  • Labs, Diagnostics test orders and tracking
  • Referral orders and tracking
  • Hospitalizations and Transition of Care

Compliance

• Collaborate in activities that ensure compliance with regulatory requirements related to:

• Quality Management Plan
• Patient care and safety
• Accreditation standards
• State and federal regulations
• Industry best practices
• Networks

Education and Training

• Stay current with regulatory requirements
• Provide education to staff on:
  • Unified Data System (UDS) metrics
  • Healthcare Effectiveness Data and Information Set (HEDIS) measures
  • Process improvement initiatives
  • Quality Methodologies: Action Plans, CQIs, PDSA, Process Mapping 
  • Quality Department New Hire Orientation

Data Analysis

• Collect and analyze data related to:
  • UDS, HEDIS
  • Quality metrics
  • Clinical audits
  • Health Resources & Services Administration (HRSA) Badges
• Create analytic reports and present data at weekly, monthly, and quarterly meetings 
• Independently develop and implement Quality Improvement Plans
• Develop UDS, HEDIS & ICT SMART (specific, measurable, attainable, realistic, time-bound) goals in Rhythm
• Contribute to the Quality Committee preparation through collaboration with Quality Improvement Manager

Survey Readiness

• Assist with maintaining robust documentation and reporting of the following:
  • Action plans
  • CQIs
  • RCAs
  • Process mapping
  • Other quality improvement/assurance activities

Works independently under the guidance of the Quality Improvement Manager

NONESSENTIAL SKILLS AND EXPERIENCE:

• Ability to communicate effectively both verbally and in writing
• Excellent customer service and communication skills
• Fluency in a language in addition to English a plus (Spanish preferred)

Additional Duties and Responsibilities

• Other duties as requested or assigned
• Provide additional support to providers by assisting with patient medical histories, taking blood pressure, administering vaccines, and educating patients

Patient Centered Medical Home (PCMH) and Integrated Care Team (ICT)

All employees are responsible for promoting and participating in interdisciplinary communication and collaboration to enhance the delivery of quality across the health care system. Employees should maintain an environment which supports and engages patients and co-workers in a caring team-based model to promote wellness and improve health outcomes.

Adherence to Compliance and Code of Conduct

All employees are required to comply with Adelante Healthcare’s written standards, including its Compliance Program and Code of Conduct, policies and procedures and reporting of any conduct that potentially violates Adelante’s legal or compliance requirements. Such compliance will be an element considered as part of the regular performance evaluation.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical demands: While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions.  The employee must frequently lift and/or move up to 25 pounds without assistance and may occasionally be required to lift or move up to 50 pounds with assistance.  Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Work environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time when traveling to various clinic sites.  The noise level in the work environment is usually moderate. The employee may be subject to health hazards (contagious diseases, blood borne pathogens, etc.) when working in the clinic area.