<p>Job Summary</p> <p>The Senior Program Quality Specialist plays a critical role in driving performance improvement and ensuring high-quality outcomes across the Network. The primary responsibility of the Senior Program Quality Specialist is to analyze, develop and implement effective "gap closure" strategies, focusing on best practices, efficiencies, and continuous process improvement. This includes identifying opportunities for closing care gaps, managing exclusion lists, and preparing the Network for future program and contract changes.</p> <p>The Senior Program Quality Specialist serves as the Network's subject matter expert on payor Measure Guides and Quality Measures, ensuring that the team has a deep understanding of all quality measures, their definitions, data collection methods, reporting requirements, and specific exclusions or gap closure guidelines.</p> <p>Additionally, this position must communicate effectively with both the Network executive team, support teams and customers to ensure alignment with the Network's overall strategy, ensuring that goals and processes are understood and coordinated across all levels.</p> <p>Responsibilities</p> <p>Gap Closure Strategies: Identify, implement, and continuously improve gap closure strategies that enhance the Network's performance on quality measures and value-based contracts.</p> <p>Payor Measure Expertise: Serve as the go-to expert on payor Measure Guides, educating teams on quality measures, including definitions, exclusions, and gap closure requirements. Ensure the team stays informed of data collection and reporting requirements.</p> <p>Process Improvement: Collaborate with leadership to design and drive Network-wide process improvements that support the achievement of quality measures and contract requirements.</p> <p>Goal Setting & Team Training: Set individual performance goals for the support teams using gap closure scorecards. Train and educate the team to maximize their impact on customer outcomes.</p> <p>Scorecard Development: Lead the development of gap closure scorecards in collaboration with the Network team. Ensure these scorecards effectively monitor progress and highlight high-priority areas for improvement.</p> <p>Exclusion Lists & Mass Uploads: Manage exclusion lists and facilitate mass data uploads to support gap closure efforts across the Network.</p> <p>Future Program Preparation: Anticipate and prepare for upcoming program (contract) changes by creating actionable roadmaps and implementing necessary process changes to avoid disruptions.</p> <p>Customer Service: Accountable for achieving superior customer service.</p> <p>Qualifications:</p> <p>Bachelor's or Associate's degree in a relevant field (E.g., Business or Health Science), with a preference for candidates holding a nursing degree.</p> <p>A minimum of 3 years of relevant experience is required demonstrating leadership across clinical and administrative teams.</p> <p>Strong proficiency in data analysis and performance measurement, with hands-on experience using relevant tools and software.</p> <p>Strong EMR proficiency, critical thinking, problem-solving skills and process improvement experience, ensuring operational efficiency and reduced loss through innovative solutions.</p> <p>Experience providing education and training to both clinical and non-clinical teams, ensuring they have the knowledge and skills to meet performance standards and quality measures.</p> <p>Knowledge, Skills & Abilities</p> <p>Education</p> <p>Bachelor's or Associate's degree in a relevant field (E.g., Business or Health Science), with a preference for candidates holding a nursing degree.</p> <p>A minimum of 3 years of relevant experience is required demonstrating leadership across clinical and administrative teams.</p> <p>Credentials</p> <ul> <li>Registered Nurse Preferred </li></ul> <p>Work Schedule: Days</p> <p>Status: Full Time Regular 1.0</p> <p>Location: Northgate-400 Association Dr.</p> <p>Location of Job: US:WV:Charleston</p> <p>Talent Acquisition Specialist: Tamara B. Young tammy.young@vandaliahealth.org</p>