What are the responsibilities and job description for the Senior Manager, Quality SCO & One Care position at C3?
Title: Senior Manager, Quality SCO & One Care
Reports to: Director, Quality
Classification: Individual Contributor
Location: Boston (Hybrid)
Job description revision number and date: V2.0; 1/13/2025
Organization Summary:
Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.
Job Summary:
The Senior Manager, Quality SCO and One Care will report to the Director of Quality and will work closely with Clinical, IT, Analytics and Behavioral Health teams. This position provides support to the organization’s Senior Care Options (SCO) & One Care Quality Programs and plays a critical role in the build, management, and implementation of the SCO & One Care annual quality plan. This position will assist in overseeing all program, measurement and performance-related initiatives directly related to SCO and One Care contracts. The Senior Manager collaborates with interdepartmental stakeholders to ensure all quality program components are achieved, accurately tracked, and reported effectively.
Responsibilities:
- Support the development, management, and implementation of the organization’s SCO and One Care quality program and annual quality plan
- Oversee ongoing quality measurement and reporting for SCO and One Care contracts, in collaboration with IT and other stakeholders
- Lead and support all committees and sub-committees as required for the SCO and One Care contracts
- Manage the development and implementation of the overall strategy for the SCO and One Care quality program including achieving goals on quality measures, clinical metrics, care coordination indicators, Star ratings, etc.
- Manage annual regulatory deliverables, including, but not limited to audits, external reviews and the timely submission of quality reports
- Collaborate and lead quality and performance improvement plans as required by the contracts with identified departments across the organization
- Provide report-outs on the progress of quality programs within the SCO and One Care contracts
- Comprehend complex data management systems to ensure all reporting requirements and needs are fulfilled
- Serve as subject matter expert on quality measures, with knowledge of the major quality measure sets including HEDIS, CAHPS, CMS, etc.
- Liaise with the Executive Director of SCO and One Care in addition to Clinical Program Leaders, Analytics, IT and other stakeholders as needed to support quality program initiatives, workflows, and data
- Interpret, verbally and in writing, quality measure specifications for multiple stakeholder groups
- Understand the requirements for valid and reliable quality measurement and reporting and the sources of quality data within provider organizations
- Develop and deliver Quality Program communications and trainings on measures, reports, and initiatives
- Act as a super user and subject matter expert for the organization's population health management platform(s), and other relevant technical platforms such as claims-processing, for SCO and One Care
- Effectively utilize population health platform(s) and other data sources to produce performance summaries, dashboards, and reports as needed
- Coordinate the ongoing validation and root cause analyses of quality measure reporting and proactively identify opportunities for improvement and gap-closure
- Support the annual evaluation of the Quality Program as well as ad-hoc evaluation as needed
- Other duties as assigned
Required Skills:
- 5 years’ related experience, preferably within a health plan, or community health/outpatient setting
- Working knowledge of quality programs including measurement and reporting, preferably through Medicaid and/or Medicare programs
- Proficient in Microsoft Office, specifically excel with building and maintaining spreadsheets, and PowerPoint development of slide presentations
- Comfortable multi-tasking and working at a fast pace
- Strong project management, analytics and program development experience
- A self-starter who can exercise high degree of initiative, judgment, discretion and decision-making to achieve objectives
- Behaves with great integrity and produces accurate work with close attention to detail, especially in the completion of final deliverables to internal and external stakeholders
- A strong commitment to the organization’s mission
- Must be able to remain in a stationary position 50-75% of the time
Desired Other Skills:
- Experience with Senior Care Options, One Care or other health plans
- Familiarity with the MassHealth ACO program
- Familiarity with Federally Qualified Health Centers
- Previous management experience
- Experience with Data Warehouses, Population Health and Analytic Platforms, Claims-Processing Systems and Electronic Health Records
- Experience with anti-racism activities, and/or lived experience with racism is highly preferred
Qualifications:
- Bachelor’s Degree preferred or appropriate experience in lieu of education
** In compliance with Covid-19 Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **
