Working under the direction of Senior Vice President, Private Market Innovations, Director, Clinical Affairs is responsible for working on efforts in the Clinical Affairs and Strategic Planning Department focused on performance measurement, health plan standards, as well as specific policy and regulatory issues including pertaining to quality, measurement, and payment. This position requires strong analytical and oral and written communication skills; ability to work with diverse stakeholders and think strategically; demonstrated experience in working with stakeholders to achieve consensus is preferable.
- Work with supervisor and Clinical Affairs and Strategic Planning staff on issues relating to quality (e.g. performance measurement, health plan standards, patient safety):
Lead tracking, identifying, and analyzing key regulatory and policy changes especially pertaining to health care quality, performance measurement and payment:
- Track and monitor performance measure projects, identify key measurement/health plan standards issues, prioritize activities, and track deadlines;
- Analyze current performance measurement projects/reports from key organizations such as the National Quality Forum, CMS, AMA PCPI, and NCQA including implications for health plans and develop draft comments;
- Solicit member feedback on quality related issues, analyze and synthesize feedback and prepare comment letters for submission to relevant organizations.
- Help manage work of Core Quality Measures Collaborative including interactions with stakeholders, preparing and synthesizing meeting materials and workgroup discussions, tracking and analyzing implications of changing measurement and reporting landscape
Attend meetings and interact with staff at health plans, NQF, and NCQA and other relevant organizations actively engaged in health care quality. Represent AHIP at external meetings such as NCQA CPM Lead tracking and communicating of health plan efforts to improve quality of care for their populations and role of quality measures in payment and delivery system reform Other tasks and duties as assigned.
- Conduct back ground research on origin of relevant policies, regulations, and/or published research findings;
- Analyze and synthesize information to produce letters, recommendations, and draft action plans; and
- Translate results into a wide range of high quality products used for responding to media inquiries, commenting through the federal rule-making process, constructing issue briefs, etc.