Job Summary: Develop, implement and oversee quality improvement to ensure delivery of the highest quality patient care, optimal patient flow, provider productivity and continuity of care. Develop a conceptual framework for quality measurement and improvement activities across clinic sites.
Responsibilities:
Develop, implement and oversee quality improvement to ensure delivery of the highest quality patient care, optimal patient flow, provider productivity and continuity of care.
Develop a conceptual framework for quality measurement and improvement activities across clinic sites.
Summarize findings in the annual Quality Improvement (QI) Plan.
Work with CEO, COO, CFO, Medical Director, and Assistant Medical Director as well as members of Management to develop and ensure the implementation of policies to minimize risk within the organization.
Manage and oversee Clinical Coordinators, Population Health Specialist and Care Coordinators.
Coordinate with the Data Analyst, OSIS and EMR Super User to develop audit systems, perform data analysis and prepare reports related to measuring objectives and tracking outcomes as required by grants, contracts.
Participate in quality components of CCPM – Accountable Care Organization
Lead controlled Substance Management and processing violations.
Work with the Medical Director and Assistant Medical Director to develop new or update existing clinical outcome measures, protocols, policies and procedures to ensure compliance with policies through a peer review process
Engages in the planning and implementation of the Corporate Compliance Program, including risk management reduction,
Investigate and act, in conjunction with COO, on matters related to compliance, including coordinate internal investigations and any resulting corrective action with all departments, contracted vendors, etc.
Develop and review policies and programs that encourage managers and employees to report suspected fraud or other improprieties.
Participate in long-range planning including the evaluation of patient satisfaction, current services and programs to increase, and market services to the community and to position Clinic for change and growth.
Academic Qualification: Nursing/health related degree and current licensure, as applicable, in nursing, public health
Experience:
A minimum of 5-8 year’s related work experience in quality management, utilization or risk management areas or equivalent combination of education and experience.
Understanding of clinical quality guidelines, compliance and policy development.
Key Skills & Competencies:
Strong level of confidentiality due to the sensitivity of materials and information handled
Computer literacy
Excellent written and oral communications kills
Good organizational skills to handle multiple priorities while remaining professional and calm
Ability to work with many diverse people
Effective telephone skills
Written and verbal communication and problem-solving skills.
Demonstrated effectiveness in the realization of performance objectives and previous experience in performance-based evaluations.
Ability to work as a liaison with patients, government agencies, grantors, managed care and other health care organizations to coordinate quality measurement and performance activities and possess the ability to communicate with people from a variety of socioeconomic and cultural backgrounds.
Ability to prioritize, organize, carry out work assignments independently and efficiently and have the ability to work independently and be self-directed and flexible.
Must be able to make suggestions on workflow or system efficiency and effectiveness.
Ability to build and motivate teams with demonstrated leadership and facilitation experience.
A commitment to the mission of Clinics.