AIDS Healthcare Foundation

Associate Director of Quality

US-CA-Los Angeles
Req No
2016-5220
Category
Managed Care
Type
Regular Full-Time

Overview

AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!

 

Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

 

If so, AIDS Healthcare Foundation is the place for you!

 

Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

  

AHF’s core values are to be:

 

• Patient-Centered

• Value Employees

• Respect for Diversity

• Nimble

• Fight for What’s Right

 

 

STILL INTERESTED? Please continue!

 

 

AIDS Healthcare Foundation is seeking a full-time, Associate Director of Quality to assist at our Managed Care Division located at the following address:

 

1001 North Martel Avenue

Los Angeles, California 90046

 

Hours of Operations:  Monday - Friday, 8:30am-5:30pm

Responsibilities

Under minimal supervision, the Associate Director of Quality carries out the day to day management and operations of the Quality Department managing staff and projects to accomplish its goals and objectives.  This position is responsible for all quality of care complaints and grievances including timely processing, tracking data and analysis and presentation of outcomes and improvement efforts around trending issues.  The Associate Director of Quality also handles all internal potential quality improvement issues, root cause analysis and or other assigned investigations.

 

This position assist the organization by leading or participating projects and clinical programs designed to make care safer, promote effective coordination of care, promote preventive care, help communities support better health, reduce costs of care through utilization management, and promote person-centered care. This position is responsible for coordinating and implementing a broad range of collaborative activities among private and public entities to improve health and health care for all Medicare beneficiaries, Medicaid recipients/enrollees, Ryan White Grant clients, other third party payer clients and AHF Healthcare Centers nationwide.

 

Quality and Performance Improvement

  • Manages, completes and submits required analyses and reports to meet regulatory and accreditation requirements (e.g., Grievances, HEDIS, UM/CM Dashboard).
  • Coordinates activities of internal departments, external partners, and external vendors for quality analysis and reporting.
  • Collaborates with health care providers to develop and implement interventions designed to promote health and wellness and improve organizational performance based on trended results of data from Grievances and UM/CM.
  • Provides technical support to the organization that includes but is not limited to: designing process maps, performing gap analysis, conducting root cause analysis, directing implementation of interventions, identifying and overcoming barriers, and instigating organizational culture change.
  • Builds sustainable relationships with internal and external customers, utilizing knowledge and skills to provide references.
  • Performs the functions required and maintains certification as the Facility Site Review Nurse.
  • Prepares supporting documentation for accreditation, audits and surveys.
  • Communicates/consults with healthcare providers to assist with advancing their quality improvement objectives.
  • Communicates and works well on tasks with ancillary and ad hoc team members, partners and stakeholders to plan, facilitate, and execute improvement activities.
  • Remains current and knowledgeable about new initiatives, including the healthcare environment, activities, tools, and techniques through research, training, education, and a variety of nationally recognized sources.
  • Routinely, accurately and concisely, documents and reports on project status, onsite visit activities, provider activities, and barriers/solutions using appropriate company and/or reporting tools and databases.
  • Collaborates with written reports, proposals, and project budgets.
  • Completes QI Assessment annually.

 

 

Dimensions of Practice

 

  • Leads and directs the work of others. Supervise, mentor and develop staff and ensure appropriate, educational programs, orientation and training courses to maintain current and future competency.
  • Leads large scale quality improvement program initiatives and major health outcomes improvement projects, facilitates continuous departmental (divisional) process projects and quality improvement activities to measurably improve the health of people living with HIV/AIDS
  • Evaluates data needs and collaborates with Information Technology Department and other analytics teams to identify opportunities to support organizational goals.
  • Designs, develops and implements solutions that address the identified opportunity.
  • Assesses, reviews, and educates providers regarding the quality of care and services provided to their members through on-site assessments and data analysis.
  • Provides assistance with the design, development and implementation of solutions which address opportunities identified by provider data or IHS staff for improvement.
  • Participates in the annual update of quality improvement (QI) program description and QI work plan.
  • Reviews documentation for compliance; audits processes; interviews appropriate management, and staff; assists with gap analysis and the development and monitoring of corrective action plans.

 

Analytics and Informatics

  • Defines required data needed and data validation for assigned projects in collaboration with IT or other appropriate resource such as a vendor.
  • Produces accurate and appropriate displays of data to analyze trends and recommend action.
  • Communicates data reports to appropriate committees.

 

Leadership and Systems Thinking

  • Demonstrates initiative in the review, comprehension and implementation of contracts and regulations that effect the deliverables required of the QI Department.
  • Facilitates and implements quality improvement and evaluation initiatives.
  • Facilitates and implements health analytics initiatives.
  • Keeps abreast of national trends and is active nationally within the quality and performance improvement space.
  • Contributes to a work environment where continuous quality improvement in service and professional practice are pursued.

 

Policy Development and Program Planning

  • Serves on AHF committees involved in quality improvement, health improvement and policy development related to health informatics, health information exchange, quality improvement and/or accreditation.
  • Write policies and procedures related to Grievances and manages their annual review and updating.

 

Communication and Cultural Competency

  • Delivers targeted, culturally-appropriate information to help individuals and groups understand health promotion and disease prevention information, policies, and regulations.
  • Maintains current knowledge of HIV/AIDS social and clinical issues and incorporates that knowledge into the quality improvement activities performed.      
  • Keeps National QI Director informed all status of all projects, initiative and programs and request direction and resources if needed.

 

Other

  • Assumes responsibility for own professional growth and development by pursuing education, participating in professional committees and work groups and contributing to a work environment where continuous improvements in practice are pursued.
  • Attends a minimum of one HIV/AIDS related educational event per year.

Supervisory Responsibilities

Supervises the Grievance Process and Facility Site Reviews.

Supervises the Quality Improvement Staff, as requested, by National Quality Director.

 

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 accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Desired knowledge, skills & abilities include:

  • Strong knowledge of accreditation, federal and state regulations/requirements.
  • Strong analytical and problem solving skills
  • Excellent verbal and written communications skills
  • Excellent data analysis and reporting skills
  • Team player who builds effective working relationships
  • Ability to work independently and with others
  • Medical coding knowledge
  • Strong organizational skills
  • Ability to effectively collect, analyze, interpret, apply and communicate clinical and administrative data (e.g., HEDIS)


OR

 

Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.

 

Education and/or Experience

  • Bachelor's degree or higher in nursing or appropriate science or related discipline Master’s degree in public health or related field preferred.
  • Current RN license and specialty certification preferred (quality, infection control and/or patient safety).
  • 1-2 years of healthcare experience.
  • Knowledge of and experience with root cause analysis and quality improvement tools and techniques, customer service and culture change concepts.
  • Experience specific to process improvement, database entry, and maintenance and report generation preferred.
  • Knowledge of survey standards and requirements for state level managed care programs and CMS is preferred.
  • Current, active driver’s license.

 

Computer/Software Skills & Abilities

To perform this job successfully, an individual should have competent skills in Database software; Internet software; Spreadsheet software and Word Processing software, Data Analytics.

 

Language Skills

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

 

Mathematical Skills

Very High Skills:  Ability to work with mathematical concepts. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical solutions.

 

Reasoning Ability

Very High Skills:  Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

 

Computer/Software Skills & Abilities:

To perform this job successfully, an individual has should have knowledge of Microsoft Office software.

 

Microsoft

Software

Level

Skill

Word

Intermediate-Advanced

This level of skills is necessary in order to use and create a variety of templates, complex tables, merges; manage table data, sort and filter merges, and also perform basic work with existing Macros. A person with this level of skills is able to customize toolbars, import and insert graphs, embed Excel data, and elaborate reports.

The person has the skills to

·   Work with sections, create templates, use styles, and customize them.

·   Create and format complex tables, and manage table data.

·   Create Mail Merges, sort and filter them.

·   Customize Toolbars.

·   Insert graphic elements.

·   Run and record Macros.

·   Format documents, control page and document appearance, paginate and link table of contents.

 

Excel

Intermediate-Advanced

This level of skills is required to work with multiple worksheets, filter data, use integrate functions, and manipulate databases.  With this level of skills, a person understands the concepts of databases and is able to work with charts and to use the list management capabilities of Excel.

The person has the skills to

·         Create, modify, and format charts.

·         Use graphic objects to enhance worksheets and charts.

·         Filter data and manage a filtered list.

·         Perform multiple-level sorting, use sorting options, and design considerations.

·         Use mathematical, logical, statistical, and financial functions.

·         Group and dissociate data and perform interactive analysis.

·         Create and modify some Macro commands.

Access

Basic

This level of skills is required to design, create, and modify databases, tables, queries, forms, and reports.  A person with this level of skills understands the different database concepts and structures and is familiar with data validation and indexing techniques

The person has the skills to

·         Plan, conceive, create, save, manage, and maintain a database.

·         Modify a database structure.

·         Generate new records and modify them.

·         Create tables with Table Wizard and in Design View and work with them.

·         Find, edit, filter, and sort records.

·         Create and use Select Queries to view specific records and to perform calculations.

·         Create, use, and customize forms, and reports.

·         Work with Data Access Pages.

Power Point

Advanced

This level of skills is desired, basic skill required to customize templates and the PowerPoint environment, and to make a presentation interactive by using hyperlinks and action buttons.

The person has the skills to

·         Create a template and work with a Design template.

·         Work with graphics, animation and multimedia, inserting movies and sound.

·         Work with the Office Suite to create slides from an outline and send slides to Microsoft Word.

·         Customize PowerPoint toolbars and automate the slide production.

·         Use AutoCorrect and the Style Checker.

·         Build interactive presentations, using hyperlinks, creating interactive objects, working with Slide Show options, and using the Meeting Minder.

·         Explore online meetings and broadcast presentations.

Visio

Intermediate

This level of skill is desired to develop process flow charts, organizational charts and incorporating drawings into other documents

The person has the skills to:

·         Create a process flow or organizational diagram and insert it into documents.

·         Associate data with the shapes in the diagrams.

·         Develop charts that are connected and self populate from a database.

·         Import and export Word outlines or Visio diagrams into either program.

Internet Explorer

Advanced

This level of skill is required to conduct research, obtain data and connect with work related social networking programs.

The person has the skills to:

·         Conduct data searches

·         Manage internet and intranet sites

·         Update MC websites

·         Utilize social networking sites to expand the sphere of influence of the MC Division.

 

Certificates, Licenses and Registrations

Certified by State of California as Facility Site Review Nurse. If not certified, will obtain certification within 6 months of hire. 

 

Preference given to Certified Professional in Healthcare Quality (CPHQ). If not certified, may be asked to obtain certification within 24 months of hire.

 

 

 We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability. The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.

 

#LI-ML1

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed