Practice/Performance Improvement Associate

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Exemption Status:

Schedule Details:

Scheduled Hours:

Shift:

Hours:

Cost Center:

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 16,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

Collaborates with the Manager / Practice Improvement Facilitator (PIF) to implement Population Health Management and workflow redesign to improve performance measures for all providers in the Managed Care Network and in accountable care relationships with UMass Memorial Health (UMMH).

Supports ongoing education, consultation, and monitoring of practice, post-acute, or community-based providers and clinical staff, as each identifies and implements clinical and operational changes to achieve the optimal quality and efficiency improvements necessary for delivery of health-oriented, patient-centered, value-based care.

Partners with the Manager / PIF to assist practice, post-acute, or community-based providers and clinical staff with workflow redesign to optimize patient access, chronic and preventive care, electronic medical record use, patient-centeredness, cultural competence, and team-building.

Major Responsibilities:

• Works closely with Manager / PIF and providers to support organizing teams, defining roles and responsibilities, and developing standards of work to improve performance in quality and efficiency of care delivery. Works with provider staff to redesign workflows and processes to better serve patients. 
• Train’s providers and staff to understand and use data effectively to drive Quality Improvement (QI).
• Helps provider teams organize, prioritize, and sequence QI activities, define actionable goals and plan small-scale tests of change.
• Assists provider teams in increasing capacity for continuous QI activities and supports the maintenance of ongoing QI infrastructure.
• Helps assigned provider teams to understand characteristics of efficient, high performing organizations and establish an action plan for (any necessary adaptation and) adoption of best practices. 
• Facilitates provider teams in transition from transaction to value-based model of care that is patient-centered and population health-based.
• Assists in identifying barriers to adoption of patient-centered standards of work and works with provider teams to understand and implement changes to achieve attributes of patient-centered medical home or other value-based models and related initiatives.
• Document’s performance improvement work in keeping with established protocols. Supports department business planning and performance analysis.
• Supports implementation, enhancements, and utilization of software applications to support multiple value-based programs.
• Responsible for auditing, monitoring, and driving quality improvement initiatives across providers. Monitors Federal and State regulatory guidelines, patient experience data, and quality measures to develop timely and relevant provider-specific performance packets for quarterly utilization reviews and ongoing partner performance compliance with value-based program care protocols and care management expectations (e.g., ACO, Bundle Payment Care Improvement (BPCI-A)). 

Additional Major Responsibilities:

• Responsible for assessing quality of patient outcomes by reviewing patient case studies with post-acute partners (IRFs, SNFs, HHAs, Hospices) and internal care management and making recommendations on additional care transition interventions, changes in preferred network partner line-up.
• Assesses facility and agency alignment with preferred criteria and makes recommendations for corrective action plans when a preferred post-acute partner no longer qualifies due to deficiencies, poor performance results or lack of invested and active participation in supporting value-based program collaboration.
• Works with skilled nursing facilities on length of stay and readmission reduction strategies
• Supports UMMH Care Coordination teams in overall system-wide post-acute network strategy. Develops and supports long term care (LTC) strategy for UMMH acute patients transitioning to Mass Health / Medicaid. Support Skilled Nursing Facility (SNF), Home Health Agency (HHA) and Hospice assessments for a systemwide use of these preferred networks.
• Utilizes a wide array of Post-Acute Tools to assist in the management of the Post-Acute Network. Tools include: Salesforce, Tableau, CarePort (Insight, Guide, CM Referral Management), DataGEN, CMS Care Compare, DPH Data, OneNote, Monday.com, SHP data, HHA VBP data, and HQRP data.

Position Qualifications:

License/Certification/Education:

Required:

• Bachelor’s degree in Healthcare, Business Administration, Social Work or related field.

Experience/Skills:

Required:

• Experience working in or interfacing with different post-acute provider types (e.g., SNF, HHA, Hospice).
• Familiarity or experience working with or across different payors (e.g., Medicare, MassHealth, commercial payors).
• Familiarity with transitions of care, case management handoff to range of post-acute settings, monitoring of patient activity across the continuum of care from acute to post-acute and outpatient care.
• Ability to use personal computers and select software applications, and proficiency with Microsoft Office applications.
• Excellent interpersonal skills, including the ability to establish and maintain effective working relationships with physicians, administration, and staff. 
• Excellent verbal and written communication, organizational and project management skills. 
• Knowledge of customer service principles.
• Evidence of organizational quality improvement (QI) experience including: 
• Experience collecting and analyzing key data with corresponding deployment of interventions to improve processes and outcomes.
• Demonstrated capacity to support process improvement (e.g., experience in successful systems improvement).

Preferred:

• Current Massachusetts LPN or BA in SW.
• Five (5) years of experience, including three (3) years in a clinical post-acute setting.
• One or more years of experience. 
• Experience/knowledge of hospital/healthcare/post-acute delivery systems including electronic medical/health records, registration, scheduling, and billing systems.
• Formal training of customer service principles.
• Formal CQI or Toyota Lean-like training and experience.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.