Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management and population health services. Ben Taub Hospital (Level 1 Trauma Center) and Lyndon B. Johnson Hospital (Level 3 Trauma Center) anchor Harris Healths robust network of 39 clinics, health centers, specialty locations and virtual (telemedicine) technology. Harris Health is among an elite list of health systems in the U.S. achieving Magnet nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-centered clinics and health centers and its strong partnership with nationally recognized physician faculty, residents and researchers from Baylor College of Medicine; McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth); The University of Texas MD Anderson Cancer Center; and the Tilman J. Fertitta Family College of Medicine at the University of Houston.

JOB SUMMARY

The Sr. Manager of Quality Improvement. Regulatory Programs is responsible for overseeing and managing the quality improvement (QI) initiatives within Community Health Choice. This leader is accountable for overseeing and actively supporting the development, implementation, and management of quality deliverables related to HHSC, TDI and CMS. They are responsible for overseeing the writing of the annual HHSC Quality Assurance and Performance Improvement (QAPI) document, HHSC Performance Improvement Projects (PIPs) plans and progress reports, and CMS Quality Improvement Strategy (QIS) submission. Work to develop and oversee rapid cycle PDCAs that meet HHSC/EQRO guidelines for Medicaid STAR, CHIP, and STAR+PLUS lines of business. Sr. Manager of Quality Improvement ' Regulatory Programs is responsible for the planning, development, and implementation of quality improvement strategies and initiatives within the health plan. This role focuses on assessing health plan performance, analyzing data to identify areas for improvement, developing actionable plans, and working cross-functionally with clinical and operational teams to improve health outcomes for members.

JOB SPECIFICATIONS AND CORE COMPETENCIES

• Oversee and manage the quality teams work to complete all regulatory required quality documents, including but not limited to, HHSC QAPI, HHSC PIP Plans, HHSC PIP Progress Reports, CMS QIS submission, and HHSC Administrative Interview.
  
  
• Lead and manage health plan quality improvement programs, ensuring they align with regulatory requirements and accreditation standards. Collaborate with clinical teams, operational staff, and other stakeholders to identify, implement, and monitor QI initiatives aimed at improving health outcomes and operational efficiencies. Ensure compliance with relevant health care regulations, such as CMS, URACm, NCQA, HHSC and TDI requirements.
  
  
• Monitor and evaluate the effectiveness of quality improvement initiatives through audits, surveys, and performance metrics. Facilitate root cause analysis for issues affecting quality care and propose corrective actions to improve outcomes. Assist Director, Quality Improvement in facilitating the quality-related committees and sub-committees, providing expertise and guidance to cross-functional teams. Foster a culture of continuous improvement by promoting quality awareness and training across the organization.
  
  
• Manage the day-to-day activities of the Quality Improvement Specialist positions. Collaborate with clinical QI RNs and other members of the Quality team. Support development of an effective quality team across multiple functions.
  Actively contributes to achievement of departmental goals, as identified in Departments annual business plan, including specific departmental process improvement plans and other duties as assigned.
  
  Reports to Position Title: Director, Quality Improvement
  Employees Supervised Titles: Quality Improvement Specialist and Clinical Outcomes Specialist, Sr.
  
  QUALIFICATIONS:
  
• Education/Specialized Training/Licensure: Bachelor's degree in clinical or health care field required.
  
  
• Master's degree in a health care related field or business strongly preferred.
  
  
• Work Experience (Years and Area): 8 years progressively responsible management experience in a health care environment.
  
  
• Minimum 5 years' experience if master's degree is held
  
  
• 3 years' experience working with State of Texas HHSC/EQRO on quality deliverables preferred.
  
  
• Management Experience (Years and Area): Minimum 2 years of experience in a leadership role including managing and overseeing quality initiatives required.
  
  Software Proficiencies: Microsoft Office (Word, Excel, PowerPoint, Outlook)
  
  Job Family/Job Title Competencies
  Attention to Detail
  Taking Initiative
  Planning and Organizing
  Critical Thinking
  
  INTERPERSONAL SKILLS
  Must be able to establish and maintain collaborative working relationships across the organization to meet quality improvement and regulatory standards.
  Able to communicate with business owners in ways to gain buy-in and support meeting accreditation standards.
  Able to effectively and efficiently keep management updated and able to identify barriers and risks related to quality initiatives.
  Ability to balance multiple accountabilities and organizational change.