Manager, Quality/HEDIS Accreditation at Pediatric Associates – Laguna Hills, California

Pediatric Associates was founded in Hollywood, FL in 1955. The same clinician-led, evidence-based, medical home passion is a unifying driver for those who join Pediatric Associates Family of Companies. The Pediatric Associates Family of Companies is a growing team of Pediatricians and Pediatric Care Teammates who are excited to be part of the first nationwide Pediatric Primary Care Medical Home. We further our uniqueness by ensuring the clinician voice is leading our medical home innovations.

PRIMARY FUNCTION

Primary Functions are maintaining our contracted HEDIS performance, supervision of Patient Outreach Coordinator activities and Asthma Educations, and assisting with administration needs associated with maintaining AAAHC accreditation.

ESSENTIAL DUTIES AND RESPONSIBILITIES

This list may not include all the duties that may be assigned.

Track and monitor HEDIS performance for the organization as per contracted performance by plan.

Utilize HEDIS tracking sheet to direct outreach teams as needed to maintain needed performance metric.

Oversee the administrative aspects of accreditations.

Input and track accreditation information and task requirements.

Prepare and submit periodic reporting required by accrediting agency to maintain status.

Communicate performance trends and documentation issues to quality team for quality improvement actions.

Oversee the Asthma Chronic Disease Management program to ensure quality, performance, and effectiveness of the program.

Review, update, and maintain the asthma education provided by the educators to the patients.

Review, update, and maintain the patient facing asthma education materials on the web site, portal, and other patient education sources.

Provide asthma educations to clinical staff during orientation training and as needed.

Conduct annual education of asthma educators.

Hires, trains, coaches, counsels, and evaluates the performance of direct reports.

Completes annual employee evaluations, manages new hires and staff development.

Monitor and evaluate outreach teams’ performance, to include, but not limited to all performance evaluations, call volume, and provide coaching opportunities and corrective actions when needed.

Responsible for the supervision of training and development of new and existing patient outreach coordinators by assisting with new hire training classes and conducting refresher training.

Perform various duties as assigned.

SUPERVISORY RESPONSIBILITIES

Train and direct 6 patient outreach coordinators.

QUALIFICATIONS

EDUCATION:

Bachelors in healthcare administration, nursing, or other healthcare related field, master’s preferred.

EXPERIENCE:

5 years health care experience required.

KNOWLEDGE, SKILLS, AND ABILITIES

Strong communication skills

Strong clinical, interpersonal, organizational and communication skills

Strong English writing skills with excellent spelling, grammar, and punctuation.

Ability to manipulate data and create presentations.

Excel, Power Point, Outlook, and Word consistent with basic Microsoft Office certification.

Willing to learn the quality process as it relates to a medical practice.

Requires strong computer skills and experience with electronic health records.

Ability to work independently and as a team player.

Detail oriented, ability to multi-task

Positive attitude and display exceptional customer service skills.

Strong telephonic skills and verbal articulation skills

Ability to assess emergency situations and act accordingly.

Effective working relationships with patients, parents, guardians, co-workers, and the public

TYPICAL WORKING CONDITIONS

Non-patient facing

Potential involvement with patient when issues are escalated to the manager.

Full time remote; must be U.S. based.

Indoor work

Operates computer.

May be exposed to hazards.

Travels to business and medical offices to assist with accreditation processes.

OTHER PHYSICAL REQUIREMENTS

Requires physical movement when evaluating offices and acquisitions.

Sitting, traveling, walking, crawling, squatting, or kneeling, bending

Manual dexterity

Reach above shoulder.

Lift/carry 20 lbs. or less; Push/pull 13-25 lbs. or less.

Vision

Sense of sound, touch, taste, and smell

The Pediatric Associates Family of Companies an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.