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Senior Quality Consultant, Ops Excellence

at Cityblock Health

Remote, USA

#communityhealth #healthcare

About the Role:

We are seeking a talented Senior Quality Consultant, Ops Excellence to help manage day to day Quality Assurance/ Strategic Ops responsibilities as we scale. You’ll work closely with internal teams in a collaborative, consultative capacity to drive towards improved outcomes across all Markets within the organization. This is an exceptional opportunity for a process-oriented, hungry self-starter who is interested in a cross-functional role at a rapidly scaling organization.

Responsibilities:

• Manage multiple projects, make judgements around objectives and scope, ensure effective and efficient implementation execution.
• Development and delivery of key strategies, plans, and improvement initiatives for the CM program to include: data pursuit strategy, barrier analysis, interventions and compliance for new market implementations.
• Partnership with internal and external teams to ensure alignment on strategy as well as tactical initiatives.
• Conduct reviews/ assessments against CB P&P’s, industry standards, and best practices.Monitor, analyze data, and identify non-compliance with CB Model of Care
• Act as an operational expert and interventionist through communication, education and design of programs and strategies to assist delegated entities to meet regulatory and accrediting standards.
• Aggregate and analyze audit findings into a reportable format and report to appropriate departments.
• Participate in Care Management/Clinical Committee meetings.
• Assist with planning of formal education sessions to Market Ops teams to address non-compliance issues.
• Develop and maintain policies and procedures.
• Other projects and duties as assigned.

Requirements for the Role:

• Bachelor’s degree in Nursing, or Social Work, or Masters in Healthcare Administration preferred; however, an equivalent combination of education and experience that provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements
• Minimum 2 years clinical and non clinical auditing experience
• Strong knowledge of managed care principles and delivery systems, medical management process, accreditation and regulatory standards delegated oversight processes, and workflow systems
• Ability to strategically think and provide solutions for gaps in care delivery
• Experience with implementation or new program development.
• Knowledge of managed care compliance, CMS regulatory and NCQA standards.
• Strong ability to quickly build relationships and trust with our non clinical and clinical ops teams
• Strong understanding of Medicaid and Medicare requirements across multiple states
• Must possess a high level of organizational skills to maintain accurate records and documentation.
• Attention to detail with analytical and problem-solving capabilities.
• Knowledge of audit processes and applicable federal regulatory and accredited standards.
• Excellent verbal and written communication skills and able to maintain positive relations with internal and external partners at all levels.
• Solid presentation and facilitation skills

About Us:

Cityblock Health is the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s Sidewalk Labs along with some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.

In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.

Over the next year, we’ll grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community.

Our work is grounded in a belief in the power of a erse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team erse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from erse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community.

Our Values:

• Aim for Understanding
• Be All In
• Bring Your Whole Self
• Lean Into Discomfort
• Put Members First

Cityblock values ersity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.

We take into account an inidual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The expected salary range for this position is $81,700 to $109,500. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location.

Medical Clearance (for Member-Facing Roles):

You must complete Cityblock’s medical clearance requirements, which include, but may not be limited to, evidence of immunity to MMR, Hepatitis B, Varicella, and a TB screen, or have an approved medical or religious accommodation that precludes you from being vaccinated against these diseases.

Covid 19 Update – Please Read:

Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine. Any iniduals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. This vaccination requirement is based, in part, on recently established government requirements. The requirement is also based on the safety and effectiveness of the vaccine in protecting against COVID-19, and our shared responsibility for the health and safety of members, colleagues, and community.

The COVID-19 pandemic has severely imacted the health and lives of people around the world, including the vulnerable populations Cityblock serves. As a healthcare provider, Cityblock holds ourselves to the highest standards when promoting the health and safety of those who we serve. Given that the COVID-19 vaccines are one of the most powerful tools to fight this disease and save lives, Cityblock is implementing a COVID-19 booster mandate for Washington, D.C. employees under the guidance of local/state mandates.