Director Quality and Clinical Services
About The Position
The Quality and Clinical Services leader provides oversight and management of all quality and clinical functions across the medical group. The position is responsible for directing and coordinating quality, safety and performance improvement initiatives that provide more efficient, streamlined workflows in the ambulatory environment. Responsibilities include but are not limited to serving as subject matter expert on all quality metrics the medical group is responsible for reporting. This includes ensuring all data is captured and reported to all internal and external parties as required. The quality and clinical service leader is responsible for educating the local market on applicable quality, safety, and clinical practice standards. Provider incentive programs are managed by the position with expected alignment with national, regional and local areas of strategic focus. Patient Safety and Infection Prevention areas of accountability include deployment of national initiatives to achieve highly reliable processes, outstanding clinical outcomes and improvements to population health across the care continuum. The quality and clinical services leader may have direct reports in areas such as safety, risk, HIM, clinical services, and data management. Job Requirements This is an onsite role. Essential Function Leads and directs quality functions across the Medical Group Facilitates patient experience improvement efforts. Manages peer review and credentialing functions per applicable state rules and regulations. Serves as lead contact for medical group valued-based contracts with payers. Responsible for quality data management for the medical group. Provides oversight for patient and employee safety, including Infection Prevention activities and deployment of High Reliability practices Supports clinical competence, oversight, and compliance in all clinical functions across the medical group. Including but not limited to lab, imaging, nursing (including Advanced Practice as applicable), medical assistants. Directs HIM function for medical group and coordinates privacy standards with HIM team. Responsible for coordination of risk adjustment work in the market. Responsible for compliance with all regulatory requirements: state, federal and local. Serves as liaison of risk management activities across the medical group in conjunction with the safety team. Leads and coordinates quality improvement activity with the population health team. The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.
Requirements
- 4-6 years of Healthcare Quality experience
- Bachelors of Nursing
- Masters degree in health or related field
- Registered Nurse (RN:KY) or Advanced Practitioner Registered Nurse (ARPN:KY) or MD or PA
Responsibilities
- Leads and directs quality functions across the Medical Group
- Facilitates patient experience improvement efforts.
- Manages peer review and credentialing functions per applicable state rules and regulations.
- Serves as lead contact for medical group valued-based contracts with payers.
- Responsible for quality data management for the medical group.
- Provides oversight for patient and employee safety, including Infection Prevention activities and deployment of High Reliability practices
- Supports clinical competence, oversight, and compliance in all clinical functions across the medical group. Including but not limited to lab, imaging, nursing (including Advanced Practice as applicable), medical assistants.
- Directs HIM function for medical group and coordinates privacy standards with HIM team.
- Responsible for coordination of risk adjustment work in the market.
- Responsible for compliance with all regulatory requirements: state, federal and local.
- Serves as liaison of risk management activities across the medical group in conjunction with the safety team.
- Leads and coordinates quality improvement activity with the population health team.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
