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Professional Quality Performance Compliance Manager

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Job Location drjobs

Rochester, NY - USA

Monthly Salary drjobs

Not Disclosed

drjobs

Salary Not Disclosed

Vacancy

1 Vacancy

Job Description

Job Title: Professional Quality Performance Compliance Manager

Job Location: Rochester NY USA

Job Location Type: Remote

Job Contract Type: Fulltime

Job Seniority Level: MidSenior level

625 State St Schenectady NY 12305 USA

  • Rochester NY USA
  • Tarrytown NY USA Req #2314

Monday January 6 2025

At MVP Health Care we're on a mission to create a healthier future for everyone which requires innovative thinking and continuous improvement. To achieve this we're looking for a Professional Quality Performance Compliance Manager to join #TeamMVP. This is the opportunity for you if you have a passion for improving quality of care ensuring compliance and crossdepartment collaboration this is the opportunity for you.

What's In It For You

  • Growth opportunities to uplevel your career
  • A peoplecentric culture embracing and celebrating diverse perspectives backgrounds and experiences within our team
  • Competitive compensation and comprehensive benefits focused on wellbeing
  • An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work for and one of the Best Companies to Work For in New York

Qualifications You'll Bring

  • Bachelor's degree in nursing Social Work Business Administration Public Health or Health Sciences or related degree strongly preferred. Candidates who possess an associate degree with the related experience may also be considered.
  • 3 5 years' experience in healthcare or managed care industry preferred.
  • Medicaid Medicare and/or Quality Regulatory experience.
  • Experience with PIP CCIPs and Quality Improvement Projects required.
  • Quality regulatory experience (QPMs CMS NCQA Medicaid state programs).
  • Demonstrated use of PDSA/PDCA.
  • Application of Quality Improvement and Quality Management tools to manage and monitor regulatory reports and submissions.
  • Curiosity to foster innovation and pave the way for growth
  • Humility to play as a team
  • Commitment to being the difference for our customers in every interaction

Your Key Responsibilities

  • Participates in quality programs and projects to measure monitor and improve the quality of the care and service provided to members for Medicare and NY State Government programs.
  • Track monitor and implement programs to assure compliance with all NY and VT State and Federal quality regulations quality standards and maximize performance.
  • Helps to develop maintain socialize and submit of (where applicable) quality improvement department policies and procedures.
  • Lead State and Federal quality performance improvement projects (Performance Improvement Projects (PIP) Quality Performance Matrixes (QPMs) Chronic Condition Improvement Project (CCIP) etc.) Quality Improvement Strategy (QIS) and the quality components of HARP and Essential Plan.
  • Cross functionally manages quality projects business priorities to achieve quality goals and meet state and federal regulatory requirements.
  • Develop and maintain applicable data collection and reporting including submitting reports timely to appropriate parties for review and final submission.
  • Regularly monitor regulatory or government policy/methodology updates changes and industry news and assess and address potential impact from changes related to the product line. Incorporate updates as needed to Quality Improvement Program Description.
  • Prepare reports and present the activities and analysis to the to the appropriate agencies such as DOH DFS IPRO or internally to the Quality Committees.
  • Create and update Quality Improvement regulatory reports to maintain compliance with relevant federal state and accreditation regulations and standards.
  • Support quality leadership reporting and information needs during plan and public meetings with the regulators (CMS DOH DFS IPRO) when addressing performance and quality improvement projects.
  • Contribute to our humble pursuit of excellence by performing various responsibilities that may arise reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.

Where You'll Be

Virtual in NYS

Pay Transparency

MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors including but not limited to geographic location; relevant experience education and training; and the nature of and demand for the role.

We do not request current or historical salary information from candidates.

MVP's Inclusion Statement

At MVP Health Care we believe creating healthier communities begins with nurturing a healthy workplace. As an organization we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger and our unique perspectives are catalysts for creativity and collaboration.

MVP is an equal opportunity employer and recruits employs trains compensates and promotes without discrimination based on race color creed national origin citizenship ethnicity ancestry sex gender identity gender expression religion age marital status personal appearance sexual orientation family responsibilities familial status physical or mental disability handicapping condition medical condition pregnancy status predisposing genetic characteristics or information domestic violence victim status political affiliation military or veteran status Vietnamera or special disabled Veteran or other legally protected classifications.

To support a safe drugfree workplace preemployment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability please contact our Talent team at .

Other Details

  • Job Family Medical Management/Clinical
  • Pay Type Salary
  • Min Hiring Rate $56200.00
  • Max Hiring Rate $97569.00


Lifelancer ( ) is a talenthiring platform in Life Sciences Pharma and IT. The platform connects talent with opportunities in pharma biotech health sciences healthtech and IT domains.

For more details and to find similar roles please check out the below Lifelancer link.

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Employment Type

Full Time

About Company

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