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Quality Manager

Muskegon Family Care

Muskegon, Michigan

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JOB DETAILS
SKILLS
Accreditation Standards, Billing, Business Administration, Business Strategy, Clinical Data, Community Health, Content Management Systems (CMS), Data Analysis, Data Entry, Decision Support, Demographics, Documentation, Fax Machines, Healthcare, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Quality, Healthcare Reimbursement, Incentive Programs, Information Technology & Information Systems, Insurance, MFC (Microsoft Foundation Class) Library, Maintain Compliance, Medical Office, Medical Record System, Medical Records, National Committee for Quality Assurance (NCQA), Organizational Development/Management, Performance Reviews, Process Improvement, Public Health, Quality Assurance, Quality Management, Quality of Care, Regulatory Compliance, Risk Management, Strategic Planning, Team Player
LOCATION
Muskegon, Michigan
POSTED
Today
Quality Manager
Muskegon Family Care
2201 S. Getty St. 
Muskegon, MI 49444
 
FULL-TIME M-F 8 AM- 5 PM
 
Muskegon Family Care is looking for a Full- Time Quality Manager to join our Supportive & Collaborative Team. Muskegon Family Care offers a competitive benefit package including, Paid Time Off, Holiday Pay, Vendor Discounts, Tuition Reimbursement up to $1,500 annually, and a 401K- safe harbor contribution, we match 100% up to 3% employee contribution: 50% for the next 2% employee contribution. 

Student Loan Forgiveness: Working for Muskegon Family Care may allow you to participate in programs that forgive the balance of qualifying student loans. Information/eligibility is available from the U.S. Department of Education.
 
Position Overview
Under the direct supervision of the Chief Medical Officer, the Quality Manager is responsible for leading and directing the Quality department.  The Quality Manager is responsible for quality improvement activities of the health center necessary to achieve and maintain the highest national performance levels. The Quality Manager will analyze data to support the decision making and ensure compliance with accrediting and regulatory agencies (HRSA, NCQA, CARF, CMS, etc.) The Quality Manager will work with the executive team to develop and implement strategies consistent with the organization.
 
Essential Duties and Responsibilities
  • Ensures compliance, accreditation standards and documentation are met in all relevant areas of responsibility, i.e., CARF, PCMH, etc.
  • Develops and implements data analytic programs to capture and extrapolate clinical and demographic data from the electronic health/dental record software.
  • Participate in the development, execution and annual review of Quality policies, procedures and protocols.
  • Actively participates on various internal committees and external community initiatives as required of position, or at the request of administration.
  • Undertakes special projects as requested by administration.
  • Coordinates the monthly meeting of the QA workgroup in conjunction with the Medical Director. 
  • Prepares the summary for the QA Board committee, including Service Recovery, service improvement and incidents.
  • Ensures that the interface from EHR to Wellcentive is functioning correctly.
  • Ensures that the interface from EHR to date system is functioning correctly, along with EHR Specialist and IT.
  • Responsible for creating/customizing pertinent reports using EHR, data systems, and registries for quality improvement.
  • Participates as a member of the Safety Committee and reviews incident reports involving the safety of patients.
  • Utilizes the quality database to enter all (patient, employee, visitor, etc.) incidents and outcomes.
  • Functions as the organization’s Risk Manager in the absence of such and works on protocols and policies as necessary.
  • Supervises and evaluates the work of Medical Records, Quality Specialists, Quality Analysts, Process Improvement, Quality CHW and Quality Referral Specialists.
  • Acts as representative & liaison to Muskegon Family Care’s P.O – Affinia Health Network
  • Meets quarterly at a minimum with insurance provider representatives
  • Relays all insurance Incentive initiates to the CMO, CEO, CFO, and Billing Manager.
  • Monitors all Uniform Data System Reporting for Clinical Quality measures.
  • Enter data on insurance websites or faxes to insurance for services completed to ensure that service is included for incentives. 
  • Understands all aspects of HEDIS scores and reporting
  • Provides work on Patient Centered Medical Home initiatives in an effort to increase quality of care and Provider reimbursement.
  • Completes Tables for the Annual UDS Report
  • Assists with FTCA Redeeming Application
  • All other duties as assigned.
Supervisory Responsibilities
The Quality Manager is responsible for the supervision, evaluation and review of all personnel in the Quality Department and Medical Records Department.
 
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
 
Education, Experience, and Licensure  
  • Bachelor’s degree in business administration, Organizational Development, Public Health or related discipline, OR an equivalent combination of education and experience. 
  • Minimum 5 years’ experience in Quality Improvement.
  • Preferred: Certified Professional in Healthcare Quality (CPHQ).
 
More about Muskegon Family Care: 
MFC is a Federally Qualified Health Center that aims to improve the overall health and wellness of our community by promoting the physical, emotional and spiritual well-being of our families through comprehensive healthcare and other essential services. As a community health center, we provide a range of services far greater than an ordinary doctor's office. We develop programs and services to meet the changing needs of our community, together we create a healthier community. 

We commit to serving our patient's and our staff through our ICARE values of innovation, within a compassionate environment for all, providing access to the care needed and treating all with great respect, and offering education opportunities that result in healthy outcomes. We are better together. Teamwork makes the Dreamwork. 
 

About the Company

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Muskegon Family Care

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