Benefits Include:

• Monday - Friday Scheduling
• Paid Holidays
• PTO
• Comprehensive Medical, Dental, and Vision Coverage
• 403(b) Retirement with Employer Match
• Training and professional development opportunities

• Work-life balance as a Blue Zones participant

Position Purpose:

Under the direction of the VP of Infrastructure Optimization and the Chief Medical Officer, the Clinical Quality Manager is instrumental in the design, measurement/monitoring, implementation, and evaluation of actions to improve patient care. Primary focus for the Clinical Quality Manager is to lead the department in the quality improvement process and all associated quality programs. The Clinical Quality Manager collaborates with providers, other clinical departments and operations to establish best practices to ensure optimal outcomes for patients. Patient records maybe be reviewed for but not limited to audits, quality initiatives, performance improvement, work group initiatives, and CCO and other health plan metrics.

This individual will review data, evaluate trends, and compare with benchmark measures. The Clinical Quality Manager may recommend actions based on the review and participate in the actions taken to improve patient care on an individual or program level initiative(s). The Clinical Quality Manager serves as a resource to all staff regarding the quality and performance improvement processes and shall be responsible for oversight of all state and federal quality-related audits.

Essential Functions:

• Manages the implementation, planning, designing and successful completion of the quality improvement program
• Provides education to clinical staff on process improvement and related topics as it relates to quality improvement and metrics
• Responsible for leading care gap closures through Quality Improvement Interventions - UDS & Metric measures
• Responsible for maintaining or improving performance upon contractual and nationally required quality performance metrics, including HEDIS and customized state measures. Oversight of external contractors such as HEDIS to move towards a value-based payment model
• Identify and prioritize key quality and utilization initiatives critical for the success of performance-based payment programs
• Prepare and present reports and updates at internal and external provider related contracted local, state and federal program requirements
• Assist Residency Program with Quality Improvement Projects
• Analyzing data utilizing risk stratification tools per PCPCH requirements to maintain 5-star accreditation standards.
• Leads Patient Center Primary Care Home program ensuring requirements are met
• Responsible for leading process improvement efforts with clinical and non-clinical teams
• Leads the development of new programs and protocols that improve patient care delivery
• Monitors clinic practice efforts to ensure compliance with internal and external standards, set by local, state and federal programs.
• Tracks, trends, monitors and acts on outcomes to include identification of corrective actions that may be needed
• Oversees and is responsible for all state and federal quality-related audits
• Run PDSA cycles for identified care caps and projects

Qualifications:

• BSN, LPN or other Clinical Degree preferred; or an equivalent combination of education, training, and experience to perform the tasks required of the position
• CPHQ certification preferred
• At least 2 years of experience in a clinical quality, quality assurance or risk management in a health care setting. Experience in a federally qualified health center or community health care setting preferred
• Experience with UDS and CCO metrics strongly preferred
• Patient-centered medical home (PCMH) or patient-center primary care home (PCPCH) experience strongly preferred; Population health experience is a plus

Ready to join our team? Apply now and take the next step in your career.