Reporting to the Associate Director, Quality and Clinical Performance Improvement, the Quality Improvement Specialist supports the organization's quality and regulatory platforms across the Columbia Affiliated Physician's IPA (CAP IPA). The Quality Improvement Specialist is responsible for ensuring CAP IPA providers meet all CAP IPA membership quality requirements and reach appropriate benchmarks across participating shared savings programs.
The Quality Improvement Specialist collects and analyzes data, identifies patterns and trends, and develops actionable next steps to improve quality and reduce cost. The Quality Improvement Specialist works with CAP IPA members to train their staff in closing gaps in care, coordinate and facilitate meetings to review progress in quality programs, identifies and develops new policies and processes, and conducts patient outreach and education to meet program goals. S/he works with the Chief Medical Officer, Chief Quality Officer, and the Associate Director to identify necessary resources to improve the quality of care and support initiatives across CAP IPA members' practices. The Quality Improvement Specialist is an integral member of the health care team who works to ensure patient safety, best practices, and high quality standards of care are maintained across the organization.
Collaborate with team members to identify innovative ways to improve population health, decrease healthcare costs, and improve the patient experience
Manage and/or coordinate the collection, compilation, and analysis of data across CAP IPA quality programs
Develop and implement preventative health and chronic disease outcome improvement interventions such as newsletter articles, CAP IPA member education and outreach, patient education and outreach, etc.
Plan, develop, and implement strategies for identifying opportunities for initiatives across all CAP IPA programs
Create, produce, and deliver a range of educational and informational presentations to CAP IPA practices with the aim of reducing gaps in care and improving clinical performance
Collect and summarize performance data and identify opportunities for improvement
Work with the Program Coordinator to compose, prepare, and produce routine and non-routine performance reports
Perform chart reviews at CAP IPA practices to close gaps in care
Work with CAP IPA practice staff to set-up supplemental data processes to submit data to payors
Collaborate with payors to utilize claims data and tools to implement initiatives to achieve reduction of inappropriate utilization of services such as avoidable ER visits, duplicate tests or procedures, risk identification, and decrease avoidable readmission rates
Requires a bachelor's degree or equivalent in education and experience, plus five years of related experience
Experience working in population health, utilization review/utilization management, and/or quality improvement
New York State license to practice as a registered nurse, nurse practitioner, licensed clinical social worker or pharmacist required
Ability to work with all stakeholders: physicians, office staff, practice managers, executive suite, consultants, payor organizations, etc.
Experience with computer databases to track and analyze data
Strong communication, writing, and presentation skills, and must be comfortable presenting regularly to healthcare staff and leadership
Excellent interpersonal, organizational, and analytical skills
Ability to travel within the 5 boroughs of NYC and Westchester County
Proficiency in Microsoft Office Suite, particularly Excel
Ability to perform all other duties as required by the department and institution
Experience with HEDIS, QARR, Quality Payment Program/MIPS, PCMH
Master's Degree in Public Health, Public Administration, or other healthcare-related discipline
Experience and knowledge of managed care plan operations
Keen attention to detail and ability to prioritize and handle multiple assignments
Experience with use of Electronic Medical Records
Certification(s) in BCPS, CCM, etc.
Equal Opportunity Employer / Disability / Veteran
Columbia University is committed to the hiring of qualified local residents.
Internal Number: 503603
About Columbia University
Columbia University is one of the world's most important centers of research and at the same time a distinctive and distinguished learning environment for undergraduates and graduate students in many scholarly and professional fields. The University recognizes the importance of its location in New York City and seeks to link its research and teaching to the vast resources of a great metropolis. It seeks to attract a diverse and international faculty and student body, to support research and teaching on global issues, and to create academic relationships with many countries and regions. It expects all areas of the university to advance knowledge and learning at the highest level and to convey the products of its efforts to the world.