Senior Manager, ACO Quality Operations

Summary

Join Vytalize Health as a Sr. Manager, ACO Quality Operations and oversee the proper completion and compliance of ACO Quality Reporting procedures, including MSSP and REACH ACOs. You will serve as the subject matter expert for ACO Quality Reporting processes, manage data collection and submission, collaborate with cross-functional teams, and maintain compliance with CMS regulations. This role involves creating educational opportunities, tracking and enhancing quality performance, and working closely with various teams. You will need a Bachelor's degree in a related field, minimum 5 years of experience in healthcare quality reporting, and proven experience in MSSP Quality Reporting. Vytalize Health offers competitive compensation, comprehensive health benefits, 401k plan, generous paid time off, and more.

Requirements

• Bachelor's degree in Healthcare Administration, Public Health, Nursing, or a related field
• Minimum of 5 years of experience in healthcare quality reporting and administration
• Proven experience leading and managing MSSP Quality Reporting, GPRO data collection, and electronic quality reporting
• Creating and delivering education to internal and external stakeholders about ACO Quality
• In-depth understanding of CMS regulations, MSSP, and ACO quality reporting requirements
• Proficiency in electronic quality reporting workflows
• Excellent communication skills, both written and verbal
• This role requires a high level of attention to detail and the ability to manage multiple priorities in a fast-paced environment

Responsibilities

• Lead ACO Quality Reporting: Ensure timely and accurate reporting for MSSP, REACH. This includes oversight of GPRO, eCQMs, Medicare CQMs, and other applicable measures
• Subject Matter Expertise: Provide expert knowledge on MSSP, REACH, and Quality Payment Program (MIPS) reporting. Explain program differences and maintain updated knowledge on quality reporting content and annual changes
• Data Collection and Submission: Coordinate and support the required processes to ensure timely data collection, validation, and submission of quality measures, including CAHPS registration and contracting for MSSP and REACH
• Performance Monitoring and Improvement: Lead initiatives to track and enhance quality performance, ensuring compliance with CMS guidelines and improving ACO performance across measures
• Create Educational Content: Develop and deliver education materials and training to internal and external stakeholders, enhancing their understanding of ACO Quality Reporting and Quality Payment Program topics
• Collaborate Across Teams: Work closely with data analytics, performance teams, and external vendors to ensure efficient data collection, reporting, and performance monitoring processes. Identify workflow gaps and recommend solutions for improvement
• Compliance and CMS Guidance: Stay informed on CMS guidance and reporting updates available through ACOMS, 4i, QPP, and other partners to inform decision-making and action plans. Communicate with internal compliance team members and CMS Help Desks as needed to clarify regulations
• Project Management: Coordinate all necessary processes, resources, and tools to meet CMS reporting deadlines, managing staff and external resources to ensure project success

Preferred Qualifications

• Master's degree
• Relevant healthcare quality certification (e.g., CPHQ, RHIA, or equivalent)

Benefits

• Competitive base compensation
• Annual bonus potential
• Health benefits effective on start date; 100% coverage for base plan, up to 90% coverage on all other plans for individuals and families
• Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date
• 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary
• Unlimited (or generous) paid "Vytal Time", and 5 paid sick days after your first 90 days
• Company paid STD/LTD
• Technology setup
• Ability to help build a market leader in value-based healthcare at a rapidly growing organization