Position Details

Department: PCCN | Phx Childrens Care Network
Category: Any
Location: Telecommuting
Posting #: 549177
Date Posted: 1/28/2021
Employee Type: Regular

Position Summary

Posting Note: As a Network Quality Performance Manager, you will lead PCCN’s quality performance efforts in alignment with PCCN’s value-based contracts. Your initiatives will work with multi-disciplinary small and large teams, and measure milestones and deliverables. You will partner with network leadership, operational teams, and data and analytics in conveying complex information in an easy to understand manner. In addition to your excellent research skills, you will need to relate with all levels of management- from physicians to data analytics, to executive leadership by communicating PCCN’s performance against value-based performance measures and strategies to help meet contractual goals. Schedule: M-F 8:-- 5:00 Address: 3200 Camelback, Phoenix, AZ Note: Presently, the position is remote due to our COVID policy; this position may require working at the office in the future. Requirements: Previous experience leading and implementing quality improvement measures utilizing clinical data to improve contractual performance procedures. Solid understanding of standard standardized quality measures (NCQA,, HEDIS and CMS CARE) Proficiency skills in EXCEL, WORD, Electronic Medical Records. Proficient in data analysis using SAS/Excel/SQL or BI Experience with Medicaid and Commercial Payers Please see the requirements in further detail below:

Network Quality Performance Manager will play a key role in advancing a culture of quality and continuous quality improvement within PCCN and the practices belonging to its clinically integrated network. This role will interface with the PCCN Practice Integration, Integrated Care Coordination, and Quality Committee teams in an effort to enhance PCCN’s core competencies in advancing pediatric health through the monitoring of quality performance indicators and implementation of best practice interventions. The Network Quality Performance Manager will, under the direction of the Medical Director, develop quality initiatives for program enhancement and provider MOC opportunities. This position reports to the Medical Director.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. Quality Improvement
    • Assists Medical Director in planning, designing, implementing, and maintaining a comprehensive continuous quality improvement (QI) program.
    • Work with PCCN leadership and staff to integrate quality performance improvement into all aspects of PCCN’s clinical programs and operations.
    • Work with PCCN leadership and staff to implement a comprehensive performance improvement program for PCCN and PCCN’s practices using formal process improvement techniques including but not limited to PDSA, DMAIC, and Lean Six Sigma.
    • Serves as a subject matter expert on NCQA/HEDIS and CMS Core quality measures as well as AHCCCS quality programs for PCCN and its practices.
    • Focuses on rapid organizational transformation, develops a culture of continuous improvement and excellence, promotes standardization, efficiency, efficacy and safety across the institute.
    • Champions a data driven environment. Coordinates the capture of data and analyzes clinical information from a variety of internal and external sources relating to patient safety, utilization of resources, system problems, and other quality functions.
  2. Network Quality Interventions
    • Reviews practice performance data for trends in the context of best clinical practice as well as contractual quality goals
    • Translates performance trends into concrete plans for practice engagement, education, and process improvement.
    • In coordination with the Practice Integration team, provides ongoing process improvement support to PCCN’s practices by frequently reviewing practice-level performance and outcomes data, observing clinical work flows, identifying root causes, implementing ongoing performance improvement activities, and evaluating the effectiveness of performance improvement activities on an ongoing basis.
    • Develops and maintains a library of quality performance best practices for PCCN’s practices.
    • Regularly presents progress on practice process improvement activities to PCCN senior leadership.
    • Contributes to the development and standardization of processes and quality improvement processes within the Integrated Care Coordination team.
  3. Quality Performance Reporting
    • Represent PCCN’s quality performance priorities in meetings with internal and external stakeholders.
    • Reports data from quality initiatives to appropriate individuals, departments and committees through interpretive presentations, automated electronic reports, and/or publications.
    • Develops, manages, and maintains a performance dashboard indicating performance against contractual obligations (gaps in care, quality performance, etc) in coordination with the data and analytics team
    • In some circumstances, will assist the Phoenix Children’s Data and Analytics division in data management, reporting, and operational integration.
  4. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
1. Bachelors degree in Health Care Administration or other relevant field. Required
2. Masters degree in Health Care Administration or other clinically relevant field. Preferred
Do you meet this requirement?
1. Three years of experience utilizing clinical data (electronic health records, claims data, health surveys, patient/disease registries) Required
2. Three years of experience in developing programs around approach to contractual performance measures Required
3. Experience or exposure to coding and claims processing for clinical services Required
4. Five years of professional experience at multiple levels of the health care system Required
5. Three years of experience translating clinical data into concrete, measurable process improvement plans Required
6. Five years of extensive experience with standardized quality measures including NCQA HEDIS and CMS Core Required
7. Three years of coding experience (preferably SQL or SAS) Preferred
8. Experience working with or experience with EHRs Preferred
Do you meet this requirement?
1. Certified Professional in Health care Quality (CPHQ) or Lean Six Sigma certification Preferred
Do you meet this requirement?
Special Skills
1. Excellent verbal, written and interpersonal communication skills. Required
2. Effective critical thinking, decision-making/problem solving skills, demonstration of creativity in problem-solving, and influential leadership skills. Required
3. Computer competency skills. Experience with Excel, Word, and Electronic Medical Records. Required
4. Able to embrace and implement new technologies. Required
5. Ability to motivate and function well within a team. Required
6. The ability to “translate” between data teams and clinical teams both internally and externally Required
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Climbing Occasionally
2. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Constantly
3. Physical Requirement - Hearing Constantly
4. Physical Requirement - Pushing/pulling Occasionally
5. Physical Requirement - Reaching Frequently
6. Physical Requirement - Sitting Constantly
7. Physical Requirement - Standing Occasionally
8. Physical Requirement - Stooping/crouching/kneeling/crawling Occasionally
9. Physical Requirement - Talking Constantly
10. Physical Requirement - Walking Occasionally
11. Physical Requirement - Near Vision Frequently
12. Physical Requirement - Far Vision Occasionally
13. Physical Requirement - Color Discrimination Frequently
14. Physical Requirement - Use of keyboard, mouse and/or computer equipment Constantly
15. Physical Requirement - Lift up to 35 pounds without assistance Occasionally
16. Physical Requirement - Lift more than 35 pounds without assistance Occasionally
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply