Director of Quality Improvement

ABOUT ADOBE

Adobe Population Health (APH) is a women-owned health solutions company founded in 2018 committed to positively impacting the lives we touch. The company has a culture of inclusivity and human kindness, based in Phoenix, AZ, with satellite locations in multiple states. APH has been recognized the last two years as one of "America's Fastest-Growing Private Companies" by Inc. 5000 and has earned a "Best Places to Work" award from the Phoenix Business Journal four years in a row.

As one of the country's few fully integrated healthcare providers, APH offers a range of services which include case management, in-home/in-clinic wellness assessments, preventative care, transitional care, and social work services. APH offers customized services for Medicaid, Medicare, and the ACA/Marketplace lines of business.

POSITION PURPOSE

Adobe Population Health is searching for a Director of Quality Improvement, who plays a critical role in supporting the organization's mission to deliver value-based care and The Director of Quality Improvement is responsible for the development and oversight of quality operations, monitoring program results against targets, ensuring regulatory and internal goals are met which includes fiscal accountabilities, and establishing and maintaining an effective interface with internal and external groups which impact quality management goals and objectives. The Director of Quality Improvement will assist in developing and implementing systems that will improve quality, increase efficiency, and drive cost savings. The Director will also be instrumental in the design and evaluation of performance improvement programs, data analysis for quality metrics, and implementation of evidence-based practices across multiple states of operation.

As the Director of Quality Improvement, you will be accountable for conducting thorough business case and customer value analysis to identify appropriate quality and population health programs as well as executing the design process based on a structured and analytical approach. The Director of Quality Improvement will foster strong, ongoing relationships among internal and external business partners by leveraging their subject matter expertise and thought partnership, transferring knowledge, best practices (external and internal), methodology, and tools. In this role, the Director of Quality Improvement will lead the team in defining improvement objectives focused on clinical gap closure, health outcomes, and improved member experience.

This position was established to support APH's expansion and will report directly to the COO. The role is based at our corporate headquarters, conveniently located off the 51 freeway (16th Street and Glendale Avenue).

DUTIES & RESPONSIBILITIES

• Responsibilities include identifying the appropriate programs and communicating recommendations to a variety of internal partners and leaders.
• Responsible for facilitating meetings to secure external contracts.
• Responsible for concurrent initiatives as team lead and/or team member, based on resource requirements.
• Lead the design, implementation, and evaluation of organization-wide quality improvement (QI) initiatives.
• Develop and monitor key performance indicators (KPIs) and quality metrics to assess outcomes and identify areas for improvement.
• Collaborates with other leaders in developing, monitoring, and evaluating Healthcare Effectiveness Data Information Set (HEDIS) improvement action plans, year-round medical record review, and overread processes.
• Oversee and coordinate performance improvement projects, including root cause analysis, process mapping, and data-driven decision-making.
• Knowledge of healthcare claims, surveys, clinical, and health data.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
• Conducts member and provider outreach designed to close member gaps in care, documenting such efforts in a manner that allows collaboration with other team members and other member-facing care delivery staff.
• Analyzes quality reports and claims data to assess up-to-the-minute member compliance status to a wide variety of quality measures, utilizing this information to improve compliance and member health outcomes.
• Collaborates with a variety of in-home & community-based providers to locate non-compliant members, managing member referrals to those providers for a variety of gap-closing quality campaigns.
• Maintains access to provider reporting of gap-closure outcomes and facilitates the transmission of such information as supplemental data.
• Maintains ongoing subject matter expertise in population health, measurement science, accreditation, and quality improvement.
• Ensuring the success of visits.
• Leading meetings regarding the progress of the contract with the health plan.
• Responsible for leading meetings regarding the progress of the contract with the health plan.
• Coordinate external audits, surveys, and accreditation processes related to quality standards.
• Partner with analytics teams to extract and interpret data for meaningful quality insights.
• Use data to drive decisions, plan and implement performance improvement strategies for clinical functions and activities.
• Participate in peer review activity as appropriate.
• Perform random clinical quality audits.
• Participate and oversee Quality Assurance/Quality Improvement programs and initiatives for their region and prepare any necessary reporting for the Quality Assurance Committee.
• Other duties as assigned.

SKILLS & QUALIFICATIONS

• Seven (7) years of healthcare experience, population health preferred.
• Five (5) years of leadership and management experience preferred.
• Two (2) years of direct experience preferred.
• Proven track record of leading quality improvement initiatives in a healthcare setting.
• Strong knowledge of regulatory requirements and quality frameworks (e.g., CMS, NCQA, HEDIS, Joint Commission).
• A self-motivated and meticulous individual.
• Be systematic, highly organized, and able to articulate thoughts.
• Excellent leadership, project management, and communication skills.
• Advanced analytical skills with the ability to use data to drive decision-making.
• Experience presenting to executive leadership and governing boards.
• Experience working in a population health or value-based care environment.
• Familiarity with quality improvement in home-based care, care management, or transitions of care.
• Knowledge of risk adjustment, social determinants of health, and health equity initiatives.
• Experience with electronic health record (EHR) systems and data visualization tools (e.g., Tableau, Power BI).
• Extensive knowledge of quantitative and qualitative research methods.
• Excellent organizational and time management skills.
• Flexible with proven ability to conform to shifting priorities, demands, and timelines.
• Support internal quality systems, and internal audits, and assist with investigations of nonconforming material.
• Technically competent with various software programs including but not limited to MS Office (Excel, Word, PowerPoint).

EDUCATION, LICENSES, & CERTIFICATIONS

• Bachelor's degree in Nursing, Public Health, Healthcare Administration, or a related field is required.
• Master's degree in a relevant field is preferred.
• Certification in Healthcare Quality (e.g., CPHQ) is strongly preferred.

BENEFITS & TOTAL REWARDS

• Paid Orientation and Training
• Insurance - Medical, Dental, Vision, and Life
• 401k Plan - 3% match
• Employee Assistance Program
• Tuition Reimbursement
• Continued Education Support
• Mileage Reimbursement (if applicable)
• Referral Bonuses
• Paid Holidays (8 days)
• Flexible Paid Time Off
• Paid Volunteer Hours

CHARACTER & COMPETENCIES

• Courage - To have the courage to do the right thing at the right time.
• Ownership - To take ownership of every issue you touch.
• Respect - To respect yourself, co-workers, and for those whom you care.
• Excellence - To be excellent in all that you do.
• Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
• Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethics; Upholds organizational values.
• Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
• Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
• Problem-Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem-solving situations; Uses reason even when dealing with emotional topics.
• Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.

PHYSICAL DEMANDS & WORK ENVIRONMENT

• Occasionally required to stand.
• Occasionally required to walk.
• Continually required to sit.
• Occasionally required to climb, balance, bend, stoop, kneel, or crawl.
• Continually required to talk or hear.
• While performing the duties of this job, the noise level in the work environment is usually moderate.
• May occasionally lift and /or move more than 30 pounds.
• Must be able to physically perform the essential duties of the position which include lifting 30 lbs., transporting materials, stooping, kneeling, crouching, reaching, use of hands, balancing, walking, standing, talking, hearing, and typing.

EQUAL EMPLOYMENT OPPORTUNITY

APH is an Equal Opportunity Employer where all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.