Manager, Quality -Remote - Military veterans preferred

Job Summary

Manages, leads and/or supports quality contracts and improvement teams as needed to achieve quality and performance improvement goals. Identifies gaps opportunities for improvement of quality outcomes and collaborate across teams in development of key operational initiatives to meet gap closure rates or High-performer (Medicare Program Rating). Develops and maintains a range of programs to ensure quality improvement integrity in healthcare services across multiple channels. Supports the design, development, testing, and enhancement of enterprise-wide quality improvement strategies, including developing programs to improve the quality of care and services provided to members across all product lines. Manages clinical quality risk and quality operations review programs. Supports the development of enterprise-wide population health service delivery models utilizing Walgreens’ assets (e.g retail pharmacy, Health Corners, etc.). Fosters a culture of quality using innovation, integration, and information to support revenue and membership growth while achieving business goals.

Job Responsibilities

• Researches, defines, and establishes best practice for advanced programs, initiatives, and interventions to improve quality of care, Stars ratings and close gaps in care with quality measures.
• Innovates quality processes across all markets/products in collaboration with departments and business owners to deliver advanced programs, initiatives, and interventions to improve quality of care for consumers with partners.
• Conducts research on clinical issues and best practices to evaluate new clinical programs/services within the Walgreens enterprise.
• Summarizes clinical information in an appropriate and concise manner for the intended audience (e.g. layperson, department colleague, executive, etc.).
• Proactively establishes and maintains a broad-based understanding of the healthcare industry and uses such information to enhance the development of population health services within the company.
• Maintains strategic focus on Stars and other quality rating program initiatives while driving implementation, (i.e. steer team from project diversions that create churn and offer minimal return, and proactively reports major project risks).
• Participates in the identification of strategic partners and vendors to support the Stars rating performance.
• Develops clinical programs and solutions that leverage Walgreens capabilities to impact the Triple Aim and offer value to Walgreens customers while enhancing corporate profitability.
• Functions as a subject matter on STARS / HEDIS Measures, as well as other Clinical Quality programs across various lines of business.
• Works closely with the relevant Product Management team members to ensure that all clinical programs support the company’s Product Management strategy.
• Collaborates with other internal Walgreen’s departments including: legal compliance fulfillment, contract compliance, care plans, outcome reporting, and alignment with the Company’s long-term
• Pharmacy, Health, and Wellness strategy.
• Stays abreast of and keep the organization apprised of existing and new Federal/State legislation impacting Stars Ratings.

• Bachelor’s degree in a related field and at least four (4) years of experience of HEDIS/Quality Improvement experience.
• Experience developing, testing, and implementing one or more Clinical Quality Improvement program that has impacted large populations.
• Experience in a Medicaid or Medicare Managed Care Organization (MCO).
• Medicare Stars experience and knowledge of HEDIS quality measurements.
• Experience creating and presenting proposals, project plans, etc. to various audience levels within an organization.
• Knowledge of healthcare industry issues and trends.
• At least 2 years of experience contributing to financial decisions in the workplace.
• At least 2 years of direct leadership, indirect leadership and/or crossfunctional team leadership.
• Willing to travel up to/at least 20% of the time for business purposes (within state and out of state).

• Master’s degree , MBA , or MPH preferred
• At least 3 years of experience in the healthcare industry (payor, health system, government agency)
• Experience with project management (e.g., planning, organizing, and managing resources to bring about the successful completion of specific project goals and objectives).
• Experience presenting to and coordinating senior level meetings, including preparation of agendas, documenting meeting minutes, sending out documents to attendees.
• Experience effectively summarizing clinical information in a concise manner for the intended audience.
• Experience using time management skills such as prioritizing/organizing and tracking details and meeting deadlines of multiple projects with varying completion dates.
• Experience analyzing and reporting data in order to identify opportunities, trends, or exceptions to drive improvement of programs and increase value to stakeholders.