Ambulatory Quality Specialist

Summary

The Ambulatory Quality Specialist is an integral member of the Ambulatory Clinical Quality team, whose function is to provide guidance, support and direction to the Physician Enterprise on quality programs, value based initiatives, and regulatory requirements. The quality specialist is responsible for validating quality data, educating providers and clinical staff on quality-related workflows and facilitating development of quality performance improvement plans. This role also monitors quality reports and proactively identifies opportunities for improvement. The specialist must remain knowledgeable on the current quality, safety and regulatory guidelines to ensure they are relaying accurate information to the providers; these programs included, but are not limited to : Rural Health Clinics (RHC), the Joint Commission (JC), MIOSHA (Michigan Occupational Safety and Health Administration), Medicaid Promoting Interoperability Program, Centers for Medicare & Medicaid Services Medicare Shared Savings Program (CMS -MSSP), CMS Merit based Incentive Program (MIPS), Patient Centered Medical Home (PCMH), payer driven pay for performance programs such as PGIP. This position reports to the Manager of Ambulatory Quality and works in close collaboration with MyMichigan Medical Group (MMG) leadership and the Ambulatory Quality Department team. This position is responsible for the coordination of ongoing evaluation, redesign and adjustments of Merit-Based Incentive Payment Systems (MIPS), Meaningful Use, Patient Center Medical Home, pay for performance quality programs, and regulatory programs as identified by improvement opportunities.

Must have a positive attitude, intrinsic motivation, the ability to work with minimal direction, and the confidence and ability to lead and adapt to change. Must have the ability to interact and communicate effectively with physicians, advanced practice providers (APPs), clinical and IT staff, including business analysts associated with analytics and reporting.

Responsibilities

• (35%)
• Monitors performance of quality reports and facilitates implementation of various tactics in the ambulatory clinics that align with the organizational strategy to improve quality and regulatory performance. Assists managers / supervisors in development of Plan-Do-Check-Act (PDCA) or performance improvement tactics to improve performance.
• (25%)
• Provides education to clinical staff, management and physicians / APPs on Epic quality documentation workflows.
• (15%)
• Conducts RHC / JC audits at the Physician Enterprise clinics. Educates the staff / managers on the regulatory rules & documentation requirements. Ensures that corrective action items are completed as outlined. Escalates performance concern to MPG leadership.
• (10%)
• Assists with quality report validation, assists with identifying areas for improving data capture accuracy.
• (10%)
• Annually, assists with completion of the Physician of Michigan Accountable Care Organizations (POM ACO) Medicare Share Savings Program chart reviews and data entry into the CMS Web Interface module. Attends all training in preparation for annual reporting.
• (5%)
• Contributes to the development and implementation of specific tactics that align with organizational strategies to meet compliance and overall goals. Collaborates with colleagues, MPG leadership, and providers to coordinate performance improvement initiatives and enhanced performance in quality programming.

Other Duties and Responsibilities

Certifications and Licensures

Registered Medical Assistant (RMA) through American Medical Technologist (AMT)

Required Education

Other Information

EXPERIENCE, TRAINING AND SKILLS : Previous exposure and leadership in performance improvement teams preferred. Must be able to demonstrate the ability to lead multidisciplinary team meetings, interpret and communicate analytical reports and facilitate engagement in performance improvement initiatives. Interpersonal skills needed to communicate successfully with individuals and groups and interact with people at all levels to communicate ideas and concepts in a clear and understandable manner. MyMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft Windows. An employee may be required to participate in further learning opportunities offered by MyMichigan Health.

PHYSICAL / MENTAL REQUIREMENTS AND TYPICAL WORKING CONDITIONS

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