$120,000–$135,000 Per Year
Ambulatory Care, Auditing, Business Administration, Clinical Medicine, Clinical Nursing, Clinical Outcomes, Content Management Systems (CMS), Data Analysis, Documentation, Emergency Care, Finance, Healthcare Administration, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Quality, Healthcare Reimbursement, Hospital, Leadership, Lean Six Sigma, Maintain Compliance, Managed Care, Medicaid, Medicare, Nursing, Nursing Administration, Operational Improvement, Operations, Outpatient Care, Patient Safety, Performance Analysis, Performance Management, Performance Tuning/Optimization, Physician Assistant, Preventive Medicine, Public Health, Quality Assurance, Quality Management, Regulations, Regulatory Compliance, Regulatory Requirements, Reporting Dashboards, Revenue/Sales Reporting, Risk Analysis, Safety/Work Safety, Scorecarding, Surveillance, Team Lead/Manager, Treatment Evaluation, Trend Analysis, Variance Analysis
Who We Are
St. John's Episcopal Hospital is the only hospital providing emergency and ambulatory care to the densely populated, culturally and economically diverse, and medically underserved populations of the Rockaways and Five Towns in southern Queens County and southwestern Nassau County, New York. Celebrating over 110 years of community care, the 257-bed facility provides people of all faiths with comprehensive preventive, diagnostic treatment and rehabilitative services, regardless of ability to pay.
Come Grow With Us!
Type: Full-Time (75 hours biweekly)
Shift: Days
Hours: 8:00am - 4:30pm
Pay: $120,000 - $135,000
Job Description
The Ambulatory Quality and Patient Safety Specialist for Ambulatory Care is responsible for the execution, coordination, and continuous advancement of ambulatory quality, patient safety, performance improvement, and managed care quality initiatives across all ambulatory services. This role functions within Ambulatory Operations and Ambulatory Leadership, working in close partnership with clinical leadership, nursing, operations, population health, patient access, finance, and managed care teams to ensure ambulatory services achieve optimal clinical outcomes, regulatory compliance, and value-based financial performance.
Responsibilities
Ambulatory Quality & Performance Improvement Execution
- Lead the day-to-day implementation of ambulatory quality, patient safety, and performance improvement initiatives across all ambulatory practices.
- Execute ambulatory quality priorities aligned with enterprise strategy, regulatory requirements, and value-based care programs.
Managed Care Quality Performance & Revenue Optimization
- Serve as a key operational partner in improving ambulatory quality performance tied to managed care reimbursement and incentive revenue.
- Work collaboratively with Patient Access and Navigation Hub, Managed Care, IPA, Finance, and Population Health teams to optimize performance under payer quality programs.
Data Analytics, Reporting & Performance Surveillance
- Track and analyze data generated from internal and external sources, including but not limited to patient care evaluation studies, variance analysis, performance improvement studies, financial and revenue performance reports, departmental reviews and audits, committee minutes and action plans, external quality reporting systems and payer dashboards.
- Develop, maintain, and interpret ambulatory quality dashboards and scorecards.
- Identify trends, risks, and opportunities related to quality outcomes, patient safety, access, and financial performance.
Regulatory Readiness, Compliance & Accreditation Support
- Support continuous regulatory readiness for ambulatory services, including Joint Commission, NYSDOH, CMS, PCMH, and payer audits.
- Conduct ambulatory audits, tracers, and assessments to identify gaps in compliance, documentation, workflows, and clinical practice.
Patient Safety & Person Centered Care Culture
- Promote a culture of patient safety, transparency, and Person Centered Care culture across all ambulatory practices.
- Support the identification, investigation, documentation, and follow-up of ambulatory safety events, near misses, and incident reports.
Clinical & Operational Collaboration
- Collaborate with Ambulatory Operations, Nursing Leadership, Medical Directors, Practice Managers, Patient Access and Navigation Hub, and Population Health teams to integrate quality into daily operations.
- Assist with initiatives addressing social determinants of health (SDOH) and health-related social needs.
Qualifications
- Bachelor's degree in Healthcare Administration, Nursing, Public Health, Business Administration, or a related field (or equivalent experience).
- Minimum of 3-5 years of experience in healthcare quality, performance improvement, managed care quality, or population health.
- Experience working in ambulatory care or outpatient clinical environments.
- Demonstrated experience with HEDIS measures, Medicaid STAR ratings, Medicare quality programs, and payer quality initiatives.
- Strong working knowledge of healthcare data analytics, quality reporting, and performance improvement methodologies.
Preferred qualifications include:
- Master's degree in Healthcare Administration, Public Health, Nursing, or a related field.
- Healthcare quality manager certification (CPHQ, CQM, or equivalent).
- Clinical experience as a Physician Assistant (PA) or similar advanced clinical role.
- Experience in safety-net health systems, unionized environments, or Article 28 clinics.
- Experience working directly with Managed Medicaid and Medicare Advantage plans.
- Lean, Six Sigma, or formal quality improvement certification or training.
E
Episcopal Health Services Inc