Sr. Manager, ACO Quality Operations

Your Opportunity 

The Sr. Manager, ACO Quality Operations is responsible for overseeing and ensuring the proper completion and compliance of ACO Quality Reporting procedures, including MSSP and REACH ACOs. This role serves as the subject matter expert (SME) for ACO Quality Reporting processes, including the Quality Payment Program (MIPS) and other related reporting requirements. The Sr. Manager will manage data collection and submission, collaborate with cross-functional teams to drive performance improvements, and maintain compliance with CMS regulations. Create education opportunities and content to enhance the knowledge of internal and external customers as it relates to ACO Quality reporting, Quality Payment Program (MIPS), and applicable topics.

What you will do

• Lead ACO Quality Reporting: Ensure timely and accurate reporting for MSSP, REACH. This includes oversight of GPRO, eCQMs, Medicare CQMs, and other applicable measures. 
• Subject Matter Expertise: Provide expert knowledge on MSSP, REACH, and Quality Payment Program (MIPS) reporting. Explain program differences and maintain updated knowledge on quality reporting content and annual changes. 
• Data Collection and Submission: Coordinate and support the required processes to ensure timely data collection, validation, and submission of quality measures, including CAHPS registration and contracting for MSSP and REACH. 
• Performance Monitoring and Improvement: Lead initiatives to track and enhance quality performance, ensuring compliance with CMS guidelines and improving ACO performance across measures.  
• Create Educational Content: Develop and deliver education materials and training to internal and external stakeholders, enhancing their understanding of ACO Quality Reporting and Quality Payment Program topics. 
• Collaborate Across Teams: Work closely with data analytics, performance teams, and external vendors to ensure efficient data collection, reporting, and performance monitoring processes. Identify workflow gaps and recommend solutions for improvement. 
• Compliance and CMS Guidance: Stay informed on CMS guidance and reporting updates available through ACOMS, 4i, QPP, and other partners to inform decision-making and action plans. Communicate with internal compliance team members and CMS Help Desks as needed to clarify regulations. 
• Project Management: Coordinate all necessary processes, resources, and tools to meet CMS reporting deadlines, managing staff and external resources to ensure project success. 

What you will need 

• Bachelor's degree in Healthcare Administration, Public Health, Nursing, or a related field (Master's preferred). 
• Minimum of 5 years of experience in healthcare quality reporting and administration. 
• Proven experience leading and managing MSSP Quality Reporting, GPRO data collection, and electronic quality reporting 
• Creating and delivering education to internal and external stakeholders about ACO Quality 
• Relevant healthcare quality certification (e.g., CPHQ, RHIA, or equivalent) is preferred 
• In-depth understanding of CMS regulations, MSSP, and ACO quality reporting requirements. 
• Proficiency in electronic quality reporting workflows. 
• Excellent communication skills, both written and verbal. 

This role requires a high level of attention to detail and the ability to manage multiple priorities in a fast-paced environment. 

Benefits

• Competitive base compensation 
• Annual bonus potential 
• Health benefits effective on start date; 100% coverage for base plan, up to 90% coverage on all other plans for individuals and families  
• Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date  
• 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary 
• Unlimited (or generous) paid "Vytal Time", and 5 paid sick days after your first 90 days 
• Company paid STD/LTD 
• Technology setup  
• Ability to help build a market leader in value-based healthcare at a rapidly growing organization  

Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information.  We will also never ask for you to purchase anything; nor will we ever interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com