Quality Manager

JOB SUMMARY

Under the direction of the Chief Compliance Officer, the Quality Manager oversees the day-to-day operations of the Quality Department and the implementation of Heart of Florida Health Center's Quality Assurance and Performance Improvement (QAPI) Program. This position coordinates and monitors organizational performance related to PCMH, UDS, HEDIS, payer quality incentive programs, and other quality, regulatory, and value-based reimbursement initiatives. The Quality Manager supervises the Quality Coordinators and Quality LPNs, collaborates with clinical and operational leaders to improve patient safety and quality outcomes, supports providers with quality improvement resources, and leads data-driven performance improvement activities that promote evidence-based care, regulatory compliance, and continuous quality improvement.

QUALIFICATIONS/REQUIREMENTS

• Bachelor’s degree in a healthcare-related field required.
• Minimum of 3-5 years working in healthcare quality related field.
• Experience with PCMH, UDS, HEDIS, payer quality incentive programs, and value-based reimbursement initiatives preferred.
• Ability to work effectively with a multidisciplinary team of healthcare professionals and support staff.
• Demonstrated ability to supervise staff, delegate responsibilities, and foster a collaborative, accountable work environment.
• Excellent verbal, written, interpersonal, and organizational communication skills.
• Ability to manage multiple priorities, meet deadlines, and adapt to changing organizational needs.
• Working knowledge of healthcare regulatory, accreditation, and quality standards, including federal and state requirements applicable to FQHCs.
• Knowledge of quality improvement methodologies, performance measurement, and data-driven improvement principles preferred.
• Knowledge of adult learning principles and the ability to develop and deliver professional education and training.
• Proficiency in Microsoft Office applications and healthcare information systems.
• Demonstrates a personal and professional commitment to the mission, vision, and values of Heart of Florida Health Center.

ESSENTIAL FUNCTIONS Monitor key performance indicators, including HEDIS and UDS, and collaborate with other senior leadership to implement process and systems-level improvements to attain targets. Facilitate regular Quality Improvement meetings. Facilitate process improvements at the clinic level through the Plan, Do, Study, Act (PDSA) cycle. Track complaints and formal grievances from patients or family members and other community stakeholders and manage those that are escalated to Quality Improvement. Monitor trends in incident reports to identify opportunities for improvement in services Participate in meetings with managed care insurances to review performance on HEDIS measures and work with clinical staff to implement initiatives to improve scores. Develop and maintain policies and procedures related to quality improvement. Oversee compliance with standards to maintain PCMH accreditation. Develop and maintain corporate plans for quality improvement, following HRSA and FTCS standards and the HFHC strategic plan. Serve as a resource to staff for external and internal audits. Ensure that corrective action plans arising from audits are implemented and documented promptly. Participate in multi-organizational learning collaboratives to support evidence-based and best practice in care. Participate in appropriate regional and national organizations (e.g., FACHC and NACHC) Represent HFHC in community organizations and boards, as approved by the Director of Compliance Other duties as assigned by the Director of Compliance. PHYSICAL REQUIREMENTS While performing the duties of this job, the employee is regularly required to talk and hear. Ability to lift 20 pounds. Must be able to lift, carry and handle equipment, supplies and other work site materials according to position requirements.