On Belay Health Solutions

Manager

• Develop and lead the overall quality strategy aligned with CMS regulations, payer expectations, and organizational goals
• Guide clinical quality improvement and population health initiatives across the provider network
• Advise executive leadership on trends, risks, and opportunities related to clinical quality and performance
• Provide reporting to leadership on overall performance trends and opportunities and work with outside quality companies on successful reporting (i.e NRC, P360, etc.)
• Oversee the design and execution of quality improvement programs using methodologies such as PDSA, Lean, or Six Sigma
• Monitor and analyze performance on quality metrics including ACO measures (APP, MIPS), HEDIS, Stars, CAHPS, and other payer-specific requirements
• Establish performance benchmarks, dashboards, and action plans to drive measurable improvement in care outcomes and cost efficiency
• Ensure timely and accurate submission of all required CMS and commercial payer quality reports and translate federal and state regulations into policies and processes
• Partner with physicians, care teams, and leadership to align on quality goals and lead education and training on quality reporting and clinical best practices
• Direct and mentor a team of quality professionals, establish priorities, allocate resources, and oversee project timelines

Senior Manager, Quality

• Develop trusting relationship with patients by providing support and advocacy to help achieve health goals Coordinate transitions of patients to/from acute inpatient, skilled nursing and other settings. Assist patients in accessing community resources (e.g., food stamps, meals on wheels, subsidized housing, free legal services, Medicaid/Medicare applications, support groups etc.) Meet with patients in patient-centered and patient-preferred locations (e.g., center, facility, home, community setting). Manage low-risk referrals defined by care management program (Medical Social Work) & collaborate with social worker on action plan Engage with high-risk individuals (e.g., completed specialty appointments, adherence to post-discharge visits); may include accompanying patients to appointments Assist completion of applications to access eligible benefits Perform wellness checks in homes, participate in remote monitoring program education on individuals with specific health conditions Provide health screenings, referrals and information Deliver health education presentations Facilitate communication between all identified parties by the patient involved in care (e.g., family members, care givers, medical providers, community-based organizations). Document interactions with patients in medical record Coach / train early career Care Managers, potentially in a management role Any other related duties assigned at manager’s discretion

On Belay Health Solutions

Senior Manager, Quality

Nurse Care Manager

Nurse Care Manager