<p>Site: Mass General Brigham Health Plan Holding Company, Inc.</p> <p>Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.</p> <p>This is a remote role and can be done from most US states. It will require occasional time at the office (roughly 1x/quarter) for team meetings in Somerville, MA</p> <p>Job Summary</p> <p>Responsible for overseeing and improving clinical performance metrics and ensuring compliance with healthcare regulations and accreditation standards. Collaborates with clinical teams to develop strategies for improving patient care outcomes and ensures that clinical operations align with regulatory and quality requirements.</p> <p>Essential Functions</p> <ul> <li>Monitor and analyze clinical performance data to identify areas for improvement in patient care and outcomes. </li><li>Ensure compliance with all regulatory, accreditation, and quality standards across clinical operations. </li><li>Collaborate with clinical staff to implement performance improvement initiatives and ensure best practices in patient care. </li><li>Develop and maintain clinical performance dashboards and reports to track key metrics. </li><li>Coordinate with quality, compliance, and risk management teams to ensure alignment with organizational goals. </li><li>Provide training and education to clinical teams on performance improvement, regulatory compliance, and accreditation standards. </li><li>Conduct audits and assessments of clinical processes to ensure continuous quality improvement. </li><li>Work with leadership to set performance goals and develop action plans to achieve them. </li></ul> <p>Qualifications</p> <p>Education</p> <ul> <li>Bachelor's Degree (Nursing, Healthcare Administration, or Related Field of Study) required </li></ul> <p>Experience</p> <ul> <li>At least 3-5 years of experience in clinical performance management, compliance, or quality improvement required </li><li>Health plan quality measure knowledge (e.g. HEDIS, STARS, etc) is highly preferred </li></ul> <p>Knowledge, Skills, and Abilities</p> <ul> <li>Knowledge of healthcare regulations, accreditation standards (e.g., HEDIS, STARS, NCQA, etc.), and clinical performance metrics. </li><li>Strong analytical skills with the ability to interpret clinical data and identify improvement opportunities. </li><li>Excellent communication and collaboration skills to work effectively with clinical teams and leadership. </li><li>Detail-oriented with a strong understanding of healthcare regulations and accreditation standards. </li><li>Proficiency in performance management software and tools for tracking clinical outcomes. </li><li>Ability to lead performance improvement projects and implement evidence-based practices. </li></ul> <p>Additional Job Details (if applicable)</p> <p>Working Conditions</p> <ul> <li>This is a remote role and can be done from most US states. It will require occasional time at the office (roughly 1x/quarter) for team meetings in Somerville, MA </li></ul> <p>Remote Type</p> <p>Remote</p> <p>Work Location</p> <p>399 Revolution Drive</p> <p>Scheduled Weekly Hours</p> <p>40</p> <p>Employee Type</p> <p>Regular</p> <p>Work Shift</p> <p>Day (United States of America)</p> <p>EEO Statement:</p> <p>Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.</p> <p>Mass General Brigham Competency Framework</p> <p>At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.</p>