QUALITY SUPERVISOR-PPN
Position Summary
General Summary/Responsibilities:
The Quality Supervisor provides leadership and operational oversight for the Quality Support Teams. Specifically, the Care Navigator and Quality Care Coordinator Support Specialist teams. The Care Navigator team supports Medicare Advantage / Senior Health Connect patients, with the strategic goal of expanding outreach and quality initiatives to include all Premier Physician Network (PPN) patients and payors. The Quality Care Coordinator and Support Specialists team work to ensure all quality gaps are closed for all designated payers and contracts with PH and any associated partnerships.
This Quality Supervisor role ensures the quality support team of Care Navigators, Care Coordinators or any other members under their supervision promote effective patient engagement, patient education, outreach, accurate documentation and follow up. Achievement of quality, safety and population health and value-based goals aligned with organizational and payer performance measures. The Quality Supervisor works collaboratively with patient experience, quality and operational leadership, providers, clinical and interdisciplinary team members. This work is is done throughout the health system and community to drive improvements in patient outcomes and quality performance.
Essential Duties & Functions
Team Leadership & Oversight
• Supervise and support the quality team of Care Navigators, Coordinators or any other roles assigned n daily outreach, scheduling, and care coordination activities and other activities related to quality improvement.
• Monitor team performance, productivity, and adherence to established quality and workflow standards.
• Conduct regular team huddles and one-on-one meetings; provide coaching, training, and performance feedback.
• Foster a collaborative, patient-centered, and high-performing team culture.
Quality and Performance Management
• Monitor and evaluate performance on payer and organizational quality metrics (e.g., HEDIS, CMS Star Ratings, Readmission Improvement and other priority quality metrics).
• Identify trends, barriers, and opportunities for improvement in patient outreach and care gap closure along with medical group quality initiatives in all service lines.
• Partner with the Quality Manger & Director of Clinical and Quality Services to develop and implement improvement strategies.
• Support the transition and expansion of quality initiatives from Medicare Advantage and all payer populations as assigned
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Documentation, Data, and Reporting
• Audit Epic documentation for accuracy, timeliness, and consistency with organizational standards.
• Collect and analyze data on patient outreach, engagement, and quality outcomes.
• Develop and present reports and dashboards to Quality and Operations leadership as requested.
• Interact with all quality program platforms in and outside of the organization
Project and Program Coordination
• Lead assigned departmental projects, ensuring milestones and deliverables are met.
• Coordinate cross-functional work with Population Health, Clinical Operations, and IT teams.
• Measure and communicate project outcomes; identify best practices for replication and scalability.
Process Improvement and Compliance
• Ensure team compliance with HIPAA, organizational privacy standards, and payer documentation requirements.
• Maintain expertise in Epic workflows and payer quality programs.
• Recommend process enhancements to improve efficiency, data accuracy, and patient experience.
Other Duties & Functions:
As assigned
Qualifications
Education
Minimum Level of Education Required: Associate degree
Additional requirements:
Type of degree: Bachelors in Nursing, Healthcare Administration, or related field preferred or equivalent experience
Area of study or major: Nursing or Business
Preferred educational qualifications: Bachelors
Experience
Minimum Level of Experience Required: 3 - 5 years of job related experience
Prior job title or occupational experience: Previous management/supervisory experience required.
Prior specific functional responsibilities: Supervision of teams of 4 or more
Preferred experience: Quality Management or related clinical or healthcare management
Other experience requirements: Program management, analytics, process improvement
Knowledge/Skills
Knowledge of quality management, payor contract quality metrics, population health, chronic care management, risk factor adjustments and insurance payer Stars/incentive program initiatives preferred.
Critical thinking skills of complex integrated systems
Current or prior experience in physician office and ambulatory healthcare setting
Ability to coordinate successful interdisciplinary teams.
Energy and enthusiasm for collaboration to improve performance at all levels of the healthcare environment.
Familiarity with EPIC EMR is strongly preferred.
Self-directed
Results oriented
Presents self professionally
Demonstrated ability in Microsoft Office applications, especially Excel.
Communicates clearly and thinks quickly
Highly motivated individual with strong oral, written, and presentation skills.
Strong planning and problem-solving skills required
Interpersonal Skills
Strong organizational skills
Actively works to remove barriers in work activities
Converts negative experiences into positive interactions
Remains calm during periods of chaos
Possesses ability to work in uncomfortable and confrontational situations
Actively assists in building relationships with providers and ambulatory/hospital staff
The incumbent should have the ability to readily approach providers and ambulatory/interdisciplinary teams