As one of the nation's leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children â“ even those who may never enter our doors â“ through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.
Nemours is seeking a Manager, Quality Analytics (Primary Care), Full-Time to join our Primary Care team in Orlando, Florida.
Nemours primary care practices provide a kid-friendly, family-centered pediatric primary care experience for families in Central Florida. With 17 primary care and six urgent care practices conveniently located throughout the region, we provide quality, professional pediatric services with special attention on preventive care and whole-child wellness.
The purpose of this position is to oversee and administer all programs related to quality care within Nemours Children's Primary Care (NCPC). This work will improve the quality of care delivered by NCPC while delivering on Nemours's True North and adding value to NCPC.
Manage and oversee all functions related to Patient Centered Medical Home (PCMH).
Develop and manage processes to ensure good HEDIS scores.
Develop and manage processes to maximize Pay for Performance reimbursement.
Work collaboratively with Nemours Managed Care department and other enterprise services within Nemours to improve relationships with payors, develop improved analytics, and improved contracting.
Collaboratively work with external organizations such as payers, industry and regulatory agencies to improve quality and reimbursement for NCPC.
Oversee OPPE (Ongoing Professional Performance Evaluation) process.
Work collaboratively with the Quality committee to develop and implement Quality improvement.
Serve as a resource for other divisions within Nemours.
Prepare NCPC for value based contracting/reimbursement.
Bachelor's Degree required.
Minimum of five (5) years experience required.
Knowledge of health insurance, managed care, health care delivery and payment systems.
Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique âœBridge to a Healthy Futureâ pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.