Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Director, Quality Technology

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Director and Equivalent
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200UU Requisition #
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Lead and manage quality technology and operational improvement programs and efforts across EmblemHealth/ConnectiCare and ACPNY. Provide oversight to define and lead the implementation of ACPNY’s simplified and integrated quality program, successfully meeting the requirements of all state, federal and individual health insurer programs. Serve as the primary leader of shared and integrated quality technologies and data exchanges between ACPNY and payer entities; and as a shared services function to support quality technology/platforms within the EmblemHealth and ConnectiCare entities.  Primary activities will be leadership and support of:

  • ACPNY patient experience improvement via quality initiatives

  • STARS, QIP, HEDIS, and HCC data capture and completion activities

  • ACPNY office level process enhancement to support quality activities

  • Care delivery certifications and accreditations within ACPNY (e.g., PCMH, etc)

Work cross-functionally across ACPNY, EmblemHealth and ConnectiCare to deliver material improvements in the rate with which the organizations close quality gaps and receive quality incentive payments. 


Responsibilities:

  • Lead care coordination quality improvement initiatives across EmblemHealth, ConnectiCare and ACPNY.

  • Coordinate and lead data integrity and data sharing efforts across EmblemHealth, ConnectiCare and ACPNY with regard to all quality, risk adjustment documentation and intensity of care capture.

  • Assess care team performance and develop payer/provider coordination programs to improvement gap closure rates.

  • Design and support quality initiatives that support HEDIS, HCC, and other quality related programs across payer and provider organizations.

  • Support activities aimed at quality and care delivery certifications and accreditations which demonstrate the high-quality care provided at ACPNY.

  • Support, as needed, payer and provider quality technology implementations and enhancements.

  • Perform other job-related duties as required.

Qualifications:

  • Bachelor’s Degree

  • Master's degree in clinical discipline or business administration preferred

  • EPIC User certification

  • 10 -12 years of relevant work experience, in positions of progressively increasing responsibility/complexity required

  • Minimum of 5 years working in health care setting required

  • Ability to: design strategies to meet requirements of external agencies such as NCQA's PCMH standards; communicate project and performance updates to senior ACP leadership; design and monitor quality improvement projects across offices;

  • communicate the principles of care coordination protocols to staff required

  • Excellent communication skills (verbal, written, and presentation) to all types/levels of audiences required

  • Proficiency in Microsoft Office suite (word processing, database/spreadsheet, presentation) required

  • Good organizational skills required

  • Ability to objectively evaluate performance of care team members required

  • Commitment to enhance patient experience required

  • Experience working on quality improvement activities preferred

  • Experience with PCMH, HEDIS, HCC required

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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