Directly leads day-to-day activities related to health plan quality assessments and supervises research staff on PIP deliverables. Provides feedback and guidance to first and second reviewers to support their development in evaluation skills and increase their knowledge of PIPs, quality improvement, and implementation science. Leads technical assistance calls with the health plans and conducts the third and final review of the PIP evaluations.
Collaborates with faculty and the Director of QI to develop innovative research projects focused on health care quality topics, and that coincide with national, state, and ICHP research priorities. Conducts qualitative analyses of QI deliverables and prepares written reports for key stakeholders. Coordinates special studies and projects as directed by QI director and support completion of special studies such as Quarterly Technical Reports and focus studies. Contributes to the design and implementation of evaluation research studies, including the development of methodologies, instruments, and other tools. Prepares health plan assessment reports.
Develops efficient and effective structures and processes to facilitate the successful completion of QI-related deliverables. Leads the interpretation and administration of policies and procedures as they apply to assigned areas of responsibility and provides recommendations for developing, revising, and implementing program policy and procedures. Oversees the development and maintenance of standard operating procedures for QI deliverables. Designs and prepares content for webinars, workshops, health plan learning collaborative web portal, and other avenues for communicating QI strategies to health plans. Reviews and synthesizes literature related to implementation science, rapid-cycle PDSA, health learning systems, and other QI methods, applying key findings to the PIP process. Develops presentations that help MCOs and DMOs increase performance and deepen their understanding of QI methods that enhance PIP quality.
Collaborates with internal and external stakeholders to develop PIP topics. Identifies state and national initiatives addressing the Medicaid population and evaluates priority areas based on the state’s quality strategy. Assesses MCOs and DMOs performance on quality measures aligned with the state strategy and national Medicaid initiatives to recommend meaningful, data-drive PIP topics. These recommendations aim to address state priorities while targeting opportunities for improvement by line of business. Monitors and coordinates project planning, timelines, and task management for multiple project deliverables. Communicates with external stakeholders about project planning and updates on current projects.
Performs related duties as required or deemed appropriate to the accomplishment of the successful completion of QI deliverables and projects.