Entity: Clinical Care Associates (CCA) - Penn Primary Care (PPC) and Penn Specialty Practices (PSP) of Penn Medicine Medical Group (PMMG)

Department: Regional Physician Admin

Location: 150 Monument Road

Hours: Per Departmental Needs (Hybrid)

Summary:

Reporting to the COO, Population Health, the Director of Population Health Quality Outcomes is accountable for designing, implementing, and leading enterprise-wide quality improvement initiatives to support population health goals. This key role focuses on improving patient outcomes through proactive outreach, closing preventive health maintenance care gaps, standardizing quality care delivery, and maximizing payer incentives (targeting 4.5 Star or better performance) in value-based arrangements. This leader will leverage various tools (e.g. HEDIS dashboards, Epic Cheers and Campaigns, RAD/RED) to maximize outcomes, improve population risk capture, and facilitate operational partners to improve overall care processes through standardization and sharing of best practices.

The Director will lead process improvement efforts across the primary care enterprise to advance patient-centered care, coordination, and enhance quality measure performance. As an active participant in strategic planning for Population Health and Primary Care, the Director will work to strengthen integration between hospitals and primary care by improving access, reducing avoidable ED/inpatient utilization, and advancing quality performance.

Partners with physicians, care management, operations, contracting and analytics teams to develop and optimize high-value, patient-centered care quality and equity, supporting UPHS mission and performance goals.

Accountabilities:

Leadership, Quality Strategy & Implementation

Lead the development of new operational and clinical programs across primary care with guidance from the COO by garnering support from key stakeholders, forming planning teams, developing financial projections and presenting plans various forums to gain approval.

Design and oversee a programmatic patient outreach function to engage patients in proactive care and closure of clinical care gaps. Develop and monitor metrics to ensure successful strategy.

Leverage HEDIS dashboards to optimize payer incentive capture. Lead daily and weekly oversight of team to ensure optimal outcomes.

Administrative lead for the Penn Medicine MSSP ACOs directing improvements in quality outcomes and patient population risk capture.

Serves as the principal interface for Penn Medicine Primary Care with all primary care practice sites to facilitate prioritization of success planning initiatives, sharing of best practices and optimizing best practice sharing.

Provides input for the development of primary care strategic plan and budget. Facilitates this process in partnership with primary care leadership and ensures that annual strategic goals are linked to entity and leadership's performance targets.

Build and manage a team responsible for enterprise performance, facilitation of best practice sharing, and standardization of practice operations as it relates to population health activities.

Serves as point coordinator and leader for select PMMG functions as required or needed:

Population Health Dashboards: Work with ambulatory operations group and PMMG practices in developing and standardizing ambulatory-specific outpatient dashboards, as well as practice-specific metrics; facilitate communication and management by metric culture across ambulatory services.

Effectively uses management and clinical information systems to monitor and improve workflow, revenue cycle performance, patient access and service performance.

Addresses interdepartmental barriers to delivery of care including staffing, equipment and facilities. Ensures that care delivery in shared programs is consistent with policies and standards, federal and state laws and regulations, and accreditation requirements.

Ensures coordination and preparation of timesheets for payroll, signs and monitors timecards in compliance with FLSA and approves leave time per departmental and Health Systems policies.

Program Development & Strategy Support

Works with hospital and departmental leadership as requested in developing programs, services, and initiatives across the Health System that meet the needs of our primary care attributed patient population, anticipate future patient needs, build system loyalty, and generate profitable growth.

Works in close collaboration with department/division/entity leadership to facilitate the development of clinical and research programs as they overlap in primary care clinical operational programs.

Ensures selection and utilization of qualified, competent personnel. Uses appropriate efficiency information/data to determine staffing requirements. Provides opportunities for staff growth within area of specialty, which is reflected in professional/performance plans.

Address disparities in healthcare access and outcomes while promoting cost-effective and high-quality care models. Support adoption of digital health tools, predictive analytics, and electronic health record (EHR) optimizations to enhance care quality.

Partner with contracting to structure performance-based agreements with payers and monitor performance.

Performance Management & Analytics

Create dashboards and reporting structures to monitor key quality metrics, ED utilization, readmissions, functional outcomes, and cost performance.

Actively participates in payer program reviews, serves as a key content expert and creates action steps to maximize performance and optimize aligned clinical outcomes.

Use data to identify variation, drive accountability, and support continuous improvement.

Partner with analytics to model shared-savings impact and forecast opportunities.

Lead quarterly performance reviews with regional operational teams.

Interdisciplinary Collaboration, Education & Training

Work closely with clinical leaders, data analysts, and administrative teams to align quality efforts across departments.

Implement provider and staff training programs on best practices for quality improvement, patient-centered care, and safety protocols.

Build strong relationships with ambulatory clinical trainers and leaders.

Regulatory & Compliance

Ensure adherence to national and local quality standards, including CMS, Joint Commission, NCQA, and state regulations, including any internal compliance standards.

Maintain awareness of evolving CMS programs and adjust strategy accordingly.

Communication

Co-leads the Population Health Operations and Quality Committee, ensuring balanced attention in involving leadership of stakeholder departments, and providing periodic updates as needed regarding operational performance, including patient volumes/growth, staffing changes, patient satisfaction, process improvements, primary care program development, etc.

Manages repository of valuable tools, guides and protocols, for learning, education, and practice accessible to all Primary Care clinicians, staff, and operational leaders through utilization of SharePoint, and newsletters.

Communicates with the staff regarding primary care, specialty and Health System programs and initiatives through information sharing at meetings, grand rounds, and distribution of minutes as appropriate.

Responds to and maintains utmost communication with COO's and Departmental leadership of key stakeholders: Clinical Care Associates/Penn Medicine Medical Group, Department of Family Medicine, Division of General Internal Medicine, Division of Geriatrics, Lancaster General Health Physicians, Princeton Health, Doylestown and others as required.

Education/Experience:

Required: Bachelor's Degree Nursing, Pharmacy, Physical Therapy, Health Care administration or related field and 10+ years Healthcare experience. Inclusive of 8+ years of prior management/leadership experience, preferably in a healthcare setting. Experience in population health, or value-based care operations. Familiarity with risk adjustment, social drivers of health and quality enhancement programs.

Preferred: Master's Degree MPH, MHA, MSN, MBA 5+ years proven leadership and relationship building skills. Data-driven mindset with analytics experience. 5+ years Strong understanding of MSSP, ACO operations and value-based payment models. Experience in leading formal performance improvement activities.