- Build the foundation and playbook that drives operational efficiency, reliability, process excellence, and performance improvement in Clinical Quality, HEDIS, and Star Ratings across multiple markets
- Partner with centralized functions such as Analytics & Data Science, Solutions & Technology, and Clinical Strategy to translate complex clinical challenges into operational solutions
- Partner with in-market teams to tailor, deploy, monitor, and iterate on solutions that are responsive to the local market dynamics and context
- Lead implementation of external solutions that support Clinical Quality, HEDIS, and Star Ratings, manage performance of those solutions, and drive evolution of our overall approach
- Leverage technology and operational efficiencies to drive scale across multiple markets
- Apply a deep understanding of the federal- and state-level regulatory landscape to position Homeward to deliver value in both the near- and longer-term
- 5+ years of hands-on Medicare Clinical Quality, HEDIS, and/or Star Ratings experience
- Demonstrated experience developing, implementing, and refining Clinical Quality, HEDIS, and Star Ratings programs and operations within value-based care payment arrangements
- Superior track record of compliance leadership, including audit experience and expert knowledge of federal and state regulations
- Experience with provider engagement across internal, affiliated, and other types of provider partners
- Experience in scaling clinical operations across unique markets, with a focus on outcomes, efficiency, and compliance in Clinical Quality, HEDIS, and Star Ratings
- Experience in a high-growth, rapidly-scaling organization
- Experience with technology-enabled provider models
- Experience within a health plan Clinical Quality, HEDIS, and/or Star Rating functions
- Experience with clinical quality in Medicaid and/or ACA lines of business
- Experience addressing social determinants of health with impact and scale
- Deep commitment to one another, the people and communities we serve, and to care that enables everyone to achieve their best health
- Compassion and empathy
- Curiosity and an eagerness to listen
- Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
- Strong focus on sustainability of our business and scalability of our services, to maximize our reach and impact
- Nurturing a diverse workforce with a wide range of backgrounds, experiences, and points of view
- Taking our mission and business seriously, but not taking ourselves too seriously- having fun as we build
- Competitive salary, equity grant
- Unlimited PTO
- Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
- Company-sponsored 401k plan
- Flexible working arrangement
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Senior Manager/Director, Clinical Quality Operations - Chicago, United States - Homeward Health
Description
Homeward is a technology-enabled healthcare provider delivering quality, affordable and comprehensive care to those who don't have it. Starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.
Our vision is care that enables everyone to achieve their best health. So, we're rearchitecting the way it's delivered - leveraging breakthroughs in diagnostics, remote monitoring, and a variety of other domains, Homeward is creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality.
Most importantly, we're aligning everyone's incentives (ours, partner health plans', and members') towards getting and keeping people healthy by taking full responsibility and financial risk for the total cost of each member's healthcare and outcomes.
Homeward is co-founded by a leadership team that defined and delivered Livongo's products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.
The Opportunity
Join us in tackling healthcare for rural America We're seeking a Sr. Manager/Director, Clinical Quality Operations who is passionate about having positive societal impact, and for using technology for good - solving issues of health inequity for communities that have been perennially underserved.
You'll be responsible for end-to-end Clinical Quality Operations, ensuring that Homeward is best-in-class in developing, implementing, and improving scalable processes and operations to drive Clinical Quality and achieve top HEDIS performance and Star Ratings across multiple markets. In addition to collaborating with centralized enablement functions to ensure success, you will partner closely with in-market teams to tailor solutions and incorporate on-the-ground feedback into our broader efforts to ensure our members and clients are reaping the benefits of this work. You will shape the direction of the company as the leader responsible for these critical outcomes.
What You'll Do
What You Bring
Bonus Points:
What Shapes Our Company
Benefits
Compensation: $160,000 - $185,000 Compensation is based on qualifications, experience, skillset, and location.
At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.
Homeward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.
Senior Manager/Director, Clinical Quality Operations professionals in Chicago
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Erica Avery
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Joseph Heidenreich
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Tanishq Patil
Master's Student at University of Illinois.
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Weilong Hu
Statistician, Data Scientist
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Ritu Agarwal
Strategic Global Benefits & Compensation Leader
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Shane small
Contract Clinical Research Associate