Location: Hybrid. Most of the positions at YCCO are hybrid, meaning they have the flexibility to work both remotely and/or in-person at YCCO's office in McMinnville, OR.

COVID-19 Update for Prospective Employees: YCCO is no longer requiring COVID-19 vaccination for employees.

Department: Heath Plan Operations FLSA Status: Exempt

Reports To: Health Plan Operations Sr. Director Physical Strength: Light (L)

Summary

This position is responsible for providing ongoing programmatic management, support and tracking of Continuous Quality Improvement (CQI) strategies, interventions, projects, and deliverables, in compliance with the Oregon Health Authority (OHA) contract and delegated responsibilities. The Quality Improvement Specialist utilizes Quality Improvement (QI) principles and techniques to effect change and complete QI-based projects, assist with documentation of project goals, and monitors progress and quality of outcomes, ensuring delivery of results. This position works closely with staff to ensure collaboration, integration, and support across all service areas and leads support efforts for clinical intervention work, specific to Coordinated Care Organization (CCO) Incentive Metric and OHA contractual requirements.

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Essential Duties

Job Duties

• Leads root cause and discovery activities to determine areas for health system and/or organizational improvement.
• Develops and implements Quality Improvement strategies and interventions, in partnership with appropriate internal and external Subject Matter Experts.
• Monitors and controls Quality Improvement strategies and interventions, with ongoing updates to the Quality Program Manager and applicable Leadership.
• Utilizes proper document control methodologies to keep organized record of QI intervention work and progress.
• Proactively engages various internal and external stakeholders in Quality Improvement activities.
• Provides on-going virtual and/or on-site support to clinical and operational leadership teams and staff of network clinics in the areas of CCO Incentive Metrics support and Oregon Health Authority contractually required QI deliverables work.
• Utilizes data analysis techniques to track the progress of CCO Incentive Metrics, in partnership with Health Plan Operations Analyst, and shares detailed metric performance with clinics and Yamhill Community Care (YCCO) Leadership on a regular cadence.
• Develops and updates quality improvement policies and procedures, and Standard Operating Procedures (SOPs).
• Facilitates internal Quality Improvement Workgroup, and partners with Provider Relations Supervisor to facilitate Patient-Centered Community Care (PC3) and Metrics Subcommittee, as well as other QI-based groups, ad hoc.
• Performs quality assurance validations of project deliverables to ensure they meet the overall CCO standards and needs.
• Attends State-lead meeting to gather informational and reports pertinent details back to appropriate organizational leaders.
• Leads the on-going forward momentum and tracking of established Quality Improvement intervention work for OHA deliverables (Transformation and Quality Strategy, Performance Improvement Projects, MEPP, etc.).
• Integrates and aligns with change management approach to support improvement projects for internal and external processes.

Essential Department & Organizational Functions

• Works to cultivate and develop inclusive and equitable services, and working relationships with diverse groups of employees, community partners, and community members.
• Participates in the preparation and submission of regulatory and contract required deliverables.
• Works closely with other YCCO departments, including Health Plan Operations and Compliance to assist with audits; including the External Quality Review (EQR), as needed.
• Proposes and implements process improvements.
• Meets deadlines for completion of assigned responsibilities and projects.
• Maintains agreed upon work schedule with punctual, regular, and predictable attendance.
• Demonstrates cooperation and teamwork using a professional and respectful demeanor.
• Provides cross-training on specific job responsibilities.
• Meets identified goals that contribute to departmental goals.
• Works collaboratively in a team and matrixed (cross-department) environment with a spirit of cooperation.
• Respectfully takes direction from Supervisor.
• Other duties as assigned.

Knowledge, Skills, & Abilities

• Demonstrated understanding of Quality Improvement principles and techniques.
• Demonstrated experience with implementing Quality Improvement intervention work.
• Demonstrated ability to present information to various stakeholders in a clear and concise manner.
• Basic understanding of the structures of Oregon Medicaid and the OHA.
• Basic understanding of CCO’s.
• Ability to work independently, use sound judgment, anticipate next steps and be proactive as part of a diverse team within a Matrix or shared resources across departments work model.
• Excellent organizational skills including ability to handle multiple priorities and demands simultaneously in a dynamic work environment while maintaining high attention to detail and accuracy.
• Excellent computer skills, including Microsoft Windows, Word, Excel, and Outlook.
• Ability to communicate effectively in all forms of communication. This includes strong written, verbal, and interpersonal communication skills.
• Ability to work in an environment with diverse individuals and groups.
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions.
• Ability to accept direction and feedback, as well as tolerate and manage stress.
• Ability to remain flexible, positive, and adaptable.
• Ability to work across the YCCO region and to work remotely, as needed.

Supervisory Responsibilities

This position has no supervisory responsibility.

Qualifications

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

Education & Experience

Required:

• Bachelor’s degree in business, health administration, or related field and two (2) years of Quality Improvement experience.

OR:

• Associate’s degree and three (3) years of Quality Improvement experience.

OR:

• Any combination of education and experience that would qualify candidate for the position.

Certificates, Licenses, and/or Registrations

This position does not require any certificates, licenses, or registrations.

Physical Demands & Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this position. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, stand, walk, use hands and fingers, handle or feel, and reach with hands and arms. The employee is occasionally required to climb or balance, stoop, kneel, crouch or crawl. The employee may occasionally need to lift and/or move up to 25 pounds.

This position operates in a professional office environment and requires frequent use of standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Specific vision abilities required by this job include close vision, color vision, distance vision, depth perception, and ability to adjust focus. The noise level in the work environment is usually moderate.

This position may include occasional required or optional travel outside of the workplace, in which the employee’s personal vehicle, local transit, or other means of transportation may be used.