Clinical Quality Improvement Team Lead
Posted on: May 28, 2023
Clinical Quality Improvement Team Lead page is loaded Clinical
Quality Improvement Team Lead Apply locations Portland, OR time
type Full time posted on Posted 2 Days Ago job requisition id
2023-911 Looking for a way to make an impact and help people?Join
PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified
applicants will receive consideration for employment without regard
to status as a protected veteran or a qualified individual with a
disability, or other protected status, such as race, religion,
color, national origin, sex, sexual orientation, gender identity or
age. Diversity and Inclusion: PacificSource values the diversity of
the people we hire and serve. We are committed to creating a
diverse environment and fostering a workplace in which individual
differences are appreciated, respected and responded to in ways
that fully develop and utilize each person's talents and strengths.
Position Overview: This position will have direct oversight and
supervision of the Quality Improvement Coordinators that are part
of the Clinical Quality Improvement program. Work involves
collaborating with Health Services and other internal departments
to plan and implement value aligned quality improvement programs,
projects, and interventions across all lines of business, while
ensuring programs maintain regulatory compliance. This work will
deliver on the triple aim of improving the member's experience of
care, improving the health of populations and reducing the cost of
health care. Essential Responsibilities:
- Provide supervision, training, and support to assigned staff.
Conduct performance management and assist with hiring, staff
development, and employee retention.
- Evaluate performance of team members. Analyze results of
performance reports for each team member to determine training
needs related to personal performance and department goals.
- Lead quality improvement projects and work plans by assisting
team with the identification of new clinical improvement
opportunities through data analysis and interpretation, create
alignment between projects and work plans where applicable, and
ensure compliance with federal, state, and program
- Lead and participate in the development and implementation of
state Performance Improvement Projects (PIPs), Transformation and
Quality Strategies (TQS), CMS Chronic Condition Improvement Program
(CCIP), Quality Improvement Strategy (QIS) and applicable annual
- Accountable for timely and accurate completion of regulatory
quality activities. Present progress and results to senior and
executive level management, as needed.
- Provide leadership on quality activities and discussions where
expertise is required.
- Support Leader Standard Work through setting goals and metrics,
visual management, idea boards, huddles, 1:1s with team members,
and regular team meetings.
- Manage internal and external quality audits by preparing,
editing, and reviewing response documentation. Be present and an
active participant in response sessions.
- Develop and manage Clinical Quality policies and procedures.
Ensure annual review timelines are met and policies and procedures
are relevant, up-to-date, and compliant.
- Represent Clinical Quality team in company and community
quality programs and projects.
- Develop, write, and present specialized quality reports.
- Review Quality Improvement Coordinator's reports for accuracy,
and compliance with internal writing standards and external
- Stay current on quality measures, quality projects, and
regulatory requirements across all lines of business.
- Represent the health plan in the communities and regions we
serve to build collaborative partnerships.Supporting
- Coordinate business activities by maintaining collaborative
partnerships with key departments.
- Actively participate in various strategic and internal
committees in order to disseminate information within the
organization and represent company philosophy.
- Meet department and company performance and attendance
- Lead and/or support quality improvement activities, designated
committees, and/or task forces to ensure the delivery of quality,
cost-efficient, high quality member care.
- Build partnerships by interfacing with community stakeholders
and provider community to promote all aspects of high-quality
clinical care. -
- Represent PCS in quality capacity at community, statewide and
regional meetings to create and implement quality improvement
policy, projects, and interventions.
regulations concerning confidentiality and security of protected
- Perform other duties as assigned. SUCCESS PROFILEWork
Experience: Five years of experience in healthcare or public health
with varied clinical focus is required. Minimum of three years
health plan experience focused on program development, quality
improvement, and application of state or federal regulations.
Strong technical writing skills. Experience implementing and
managing any of the following is strongly preferred: disease
management, chronic condition management, case management, health
promotion, program development. Prior leadership or supervisory
experience preferred.Education, Certificates, Licenses: Master's
degree in Public Health or other related field required.
-Knowledge: Knowledge and understanding of health insurance,
disease prevention, care modalities, and procedure codes (including
ICD-10, CPT, and HCPCS codes). Knowledge of NCQA standards and
Medicaid and Medicare regulations. Familiarity with CMS Stars, NCQA
HEDIS metrics and state quality incentive measures. Knowledge of
quality improvement methodology. Ability to develop, review, and
evaluate utilization reports. Strong analytical and problem-solving
skills. Proven project management experience, thorough
understanding of health care operations, process improvement,
business analysis and program planning and evaluation. Experience
giving presentations. Strong organizational skills and attention to
detail. Solid experience in using computers and various software
applications including Word, Excel, PowerPoint, Outlook,
SharePoint, and audio-visual equipment. Familiarity with population
health and data management platforms. Ability to work independently
with minimal supervision.Competencies
- Building Trust
- Building a Successful Team
- Aligning Performance for Success
- Building Customer Loyalty
- Building Strategic Work Relationships
- Continuous Improvement
- Decision Making
- Facilitating Change
- Leveraging Diversity
- Driving for ResultsEnvironment: Work inside in a general office
setting with ergonomically configured equipment. Occasional
overnight travel.Our Values We live and breathe our values. In
fact, our culture is driven by these seven core values which guide
us in how we do business:
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for customer service.
- We practice open communication at all levels of the company to
foster individual, team and company growth.
- We actively participate in efforts to improve our many
communities-internally and externally.
- We actively work to advance social justice, equity, diversity
and inclusion in our workplace, the healthcare system and
- We encourage creativity, innovation, and the pursuit of
excellence.Physical Requirements:Stoop and bend. Sit and/or stand
for extended periods of time while performing core job functions.
-Repetitive motions to include typing, sorting and filing. Light
lifting and carrying of files and business materials. Ability to
read and comprehend both written and spoken English. Communicate
clearly and effectively.Disclaimer:This job description indicates
the general nature and level of work performed by employees within
this position and is subject to change. It is not designed to
contain or be interpreted as a comprehensive list of all duties,
responsibilities, and qualifications required of employees assigned
to this position. Employment remains AT-WILL at all times. Similar
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Ago PacificSource is anything but a typical health insurance
company. Founded in 1933, we're an independent, not-for-profit
organization that puts our members, and their communities
first-across Idaho, Oregon, Montana, and Washington. It's our
1,800+ employees who make it happen: promoting health equity and
partnering with providers to deliver better access to optimal,
affordable care. So yes, with PacificSource, you get to do great
things. In our effort to put members first-more than 600,000 of
them-initiative, commitment, and hard work are supported and
rewarded with excellent benefits, competitive wages, and
opportunities for personal growth and advancement. Benefits: F
lexible telecommute policy, m edical, vision, and dental insurance,
incentive program, paid time off and holidays, 401(k) plan,
volunteer opportunities, tuition reimbursement and training, life
insurance, and options such as a flexible spending account. Why
PacificSource We love our common purpose. Empowerment, flexibility,
and sharing success make for a great place to work. Here's what
else we feel good about:
- A mission with a real sense of shared values
- Competitive wages and outstanding benefits, including
- Opportunities for learning development and career
- Organizational leadership style rooted in servant and
- A commitment to support the communities we serve
- A belief in the importance of work-life balance Upcoming career
- June 20: Health Worker Regional Workforce Summit, all day at
Bend COCC Coats Center (2600 NW College Way in Bend, OR)
- August 17: Idaho Business League Job Fair, 10 a.m. - 2 p.m. at
Nampa Civic Center in Idaho
- August 23: Portland Diversity Career Fair, 11 a.m. - 3 p.m. at
Portland Expo Center (2060 N. Marine Drive in Portland, OR) Grow
your career with us PacificSource is an equal opportunity employer
and a company that loves helping people. We work with our employees
to understand their goals, and provide training, individual
development, and career advancement opportunities to help them
achieve just that. In 2022 alone we had 421 internal promotions!
- Certified Age Friendly Employer, 2023 - Age Friendly
- Top Workplace 2022 for Idaho - Idaho Press
- Top Workplace 2022 for Oregon and SW Washington - The
- #4 Healthiest Employer of Oregon 2021 - Portland Business
- Healthy Worksite 2021 - Design Coalition in Montana Affirmative
Action Program Policy Statement PacificSource is an equal
opportunity employer. Click here to review our AAP Policy
Statement. Get in touch If you have questions about working at
PacificSource or need help with your application, please email
Keywords: PacificSource, Portland , Clinical Quality Improvement Team Lead, Healthcare , Portland, Oregon
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