Senior Manager, Quality Programs
The Alliance of Community Health Plans (ACHP) is a leadership organization that brings together innovative non-profit health plans and provider organizations that are among America’s best at delivering affordable, high-quality coverage and care to their communities. ACHP member organizations provide coverage and care for more than 19 million Americans. Drawing on years of experience, member organizations collaborate to identify problems, share information and work toward solutions to some of health care’s biggest challenges. Their work is the foundation for ACHP’s advocacy on behalf of better health care nationally. More information is available at www.achp.org.
The Senior Manager of Quality Programs guides ACHP’s clinical performance improvement strategy that drives member organizations’ understanding of the care they provide for their communities. This individual designs creative health plan performance programs, strongly supported by quantitative analysis, with a dedicated focus in the areas of quality and pharmacy. The analysis and insights allow ACHP member plans to clearly understand the value of the care they provide and stay among the top rated health plans in the nation. The senior manager collaborates closely with senior quality and pharmacy leaders to coordinate learning agendas that promote innovative thinking and solutions to the critical issues affecting member plans. The senior manager also builds strong relationships with the health care quality stakeholders and positions ACHP as a visionary leader on quality measurement. Successful candidates will employ a thorough knowledge of quality measurement and health plan operations, experience with effectively presenting data, as well as an ability to facilitate adult learning environments.
This individual should be passionate about high-quality, affordable care and be an idea-generator who can help ACHP and its members further these goals. The senior manager position is a key player in the overall success of the organization, constantly identifying ways to help our members deliver higher-value care.
CORE DUTIES AND RESPONSIBILITIES
- Utilize public and member-reported health care datasets to better understand clinical performance and identify improvement opportunities.
- Oversee management of ACHP’s suite of quality and pharmacy databases, tools and resources.
- Develop analytic presentations to clearly and concisely convey insights for key internal and external audiences.
- Assist advocacy team in communicating quality performance to policymakers, thought leaders and journalists.
- Build close member relationships through ongoing engagement with senior health plan leaders to identify the critical issues affecting performance.
- Develop and coordinate ACHP’s learning agenda for the Quality Leaders and Pharmacy Directors Collaboratives.
- Manage member work groups in the areas of CMS MA Star Ratings, Clinical Analytics as well as newly identified clinically-oriented topics of interest.
- Use knowledge of health plan and provider operations in combination with analyses to develop Learning and Innovation programs to improve ACHP member performance.
- Coordinate ACHP’s internal and external reports on clinical programs and innovations, including writing on topics such as community health.
- Work closely with ACHP policy staff to advance the ACHP advocacy agenda on drug cost and public program quality rating system.
- Develop innovative thinking and ideas around the future of quality measurement.
- Serve as a liaison to the health care measurement community, including NCQA, PQA, and NQF.
PROFESSIONAL EXPERIENCE, EDUCATION AND OTHER QUALIFICATIONS
- Bachelor’s degree in statistics, economics, business, public health, nursing or similar area of study required; Graduate degree in mentioned areas strongly preferred.
- 5+ years of relevant work experience.
- Significant project management experience.
- Quantitative skills that include the ability to create data visualizations and be facile with descriptive statistics.
- Experience with Microsoft Office applications and Tableau; ability to understand Access or SQL databases a plus.
- Familiarity with a variety of health care data sources, including HEDIS, CAHPS and CMS Medicare Advantage Star Ratings.
- Familiarity with health plan quality rating systems, including those of NCQA and CMS.
- Advanced knowledge of health care markets including commercial and public lines of business.
- Understanding of health plan clinical operations; experience working at a health plan a plus.
- Ability to make the connections between health care policy and real-world business dynamics.
- Excellent judgment and critical thinking skills.
- Confident and friendly verbal communication with a customer-focused mindset.
- Demonstrated attention to detail and strong organizational abilities.