Manager, Quality

The Why Behind Wellvana:

Wellvana partners with primary care providers, hospitals and health systems to make the transition from fee-for-service to value-based care life-changing for patients and providers.

With more than a dozen ACOs in MSSP across all tracks and start years, Wellvana matches its partners with personalized paths in their value-based care journey.

By offering multiple high-touch delivery models, including guided physician enablement as well as embedded support featuring Foundational Care™ management, Wellvana layers in supporting services that help reduce the administrative load while delivering resources to patients that drive positive outcomes.

Founded in 2018 and based in Nashville, Tenn., Wellvana works with partners in over 40 states, caring for nearly a million lives across multiple payors.

Clarity on the Role:

Quality Managers require a deep understanding of CMS measure technical specifications and previous quality experience. These qualifications will ensure that the Quality Strategy is implemented and continued as designed. The Quality Manager will be the main point person for not only the Partner Success team but partners for each designated region, ensuring even workload split and continuity with partners.

What's Expected:

• Obtain and analyze the baseline assessment of clinical and EHR workflows of each assigned partner
• Work with partners as needed to further develop workflows and ensure documentation meets unique reporting requirements
• Ensure partners are knowledgeable with the Wellvana Universal Measure Set and how that differs from their end-of-year reporting requirements.
• Monitor performance monthly through a standard reporting package, develop actionable next steps for discussion with partners for continuous improvement.
• Data Optimization
• Performance Enablement
• Deliver and assist with interpretation of technical requirements needed for each program to ensure optimal performance
• Ensure supplemental data is uploaded to payor portals as applicable
• Deliver strategies that utilize established industry best practices and clinical pathways to meet and exceed measure benchmarks through utilization of multiple educational platforms and techniques
• Webinars
• Educational Content Development (e.g. Quality Measure guidebook)
• 1:1 educational support
• Ongoing education of the Partner Success Team and Growth team around annual metric changes to ensure successful engagement of both internal and external clients around quality programs
• Partner with internal teams to successfully deploy ACO REACH/PC FLEX data reporting (previously HEDR)
• Special projects as assigned (e.g. MIPS for Prospective Partners)
• Attend JOCs, monthly quality calls, and monthly action planning meetings as appropriate
• Collaborate with external vendor to ensure end of year quality reporting is evaluated and submitted based on based overall score for each ACO

What's Required:

Live Out the Wellvana Way

• Find a way. Be accountable, see the work through, make it life changing.
• Ask why question. Conventional wisdom is often wrong. Be curious and always connect your work back to the goal and audience.
• Move on what matters: Prioritize the work and be laser focused on what moves the needle.
• Expect to win: Confidence is contagious. Bring solutions.
• You can’t do it alone. And you’re not expected to. We work best when we’re a team. Silos slow us down. Collaboration and communication are the fast way… and the fun way.

Education

• Bachelor’s degree in a related field and/or the equivalent combination of training, education, and experience, required

Years of Related Experience

• 3-5 years in a healthcare related field

Skills/Competencies/Behaviors

• Strong time management and organizational skills. Able to meet assigned deadlines.
• Knowledge of CMS program requirements for each line of business
• Nashville candidates preferred