Chief of Quality

Primary Responsibilities and Specific Duties:

  • Aligns Providers to improve the cost and quality of care

  • Advises the Executive Leadership team on emerging trends, methodologies or issues in billing, coding, compliance or documentation issues

  • Works to improve market position, expand continuum of care, improve organizational performance and a better patient experience

  • Works effectively on projects with outside stakeholders, grant agencies, managed care and other groups as assigned.

  • Serves as the organizations designated Medicare Compliance Officer to ensure compliance with all existing and emerging requirements related to CMS

  • Serves on Organizational Committees such as QIC, Credentialing Committee

Quality of care:

  • Promote a higher quality of care and more cost-efficient patient services, by directing better coordinating care across the continuum of conditions, providers, settings and time

  • Enhances collaboration and demonstrates compliance with recognized clinical best practices and improved outcomes.

  • Motivates and works one-on-one, in groups, at Provider Monthly Site Meetings, Provider Quarterly Meetings, or other training settings to assist Providers and/or other staff to work in a more united way to ensure the delivery of optimal, efficient care, and clinical integration.

  • The Chief of Quality tracks quality and outcome measures, an important facet of improving quality of care and increasing Pay-for-Performance (P4P) revenue along with meeting HRSA standards and goals

  • Provides analysis of data that is understandable to different audiences, such as providers and staff, leaders, executive leadership, QIC and Board of Directors

    • Monitors industry trends and takes required action on reports including Uniform Data Sets (UDS), Health Effectiveness Data Information Sets (HEDIS), Quality Dashboard, Meaningful Use, grant reports, Patient Centered Medical Home requirements and others as assigned.

    • Benchmarks performance against clinical industry standards

    • Acts also as an internal consultant and makes improvement recommendations as necessary

  • Facilitates rapid and seamless information sharing, thereby improving care continuity, eliminating duplicative diagnostic testing, and reducing the risk of medical errors

  • Promotes CHC and community-level disease management with attention to population health, thus improving overall health

  • Participates on the Quality Improvement Committee (QIC).

      • In partnership with the QIC Committee, other departments and leaders, develops, evaluates and implements process and/or policies and procedures for performance improvement. 

      • Under the direction of the Chief Medical Officer (CMO) monitors the Quality Improvement plan, updates the QI procedure as necessary, leads the QIC when designated by the CMO

      • Implements and facilitates cross-functional teams to complete projects or assignments.

        • Able to work effectively on project with outside stakeholders, grant agencies.

      • Participates in periodic mock surveys to assess accreditation preparedness.

Cost control:

  • In addition to improving the quality of care, the Chief of Quality assists to reduce overall expenditures by managing costs at the patient level

  • Participates and acts as a liaison with all managed care organizations and other Payers as contracted with CHC and coordinates data for action

  • Ensures compliance with all applicable regulatory agencies and internal policies.

  • Other duties as assigned


Qualifications:

Education: 

  • MD or DO

Experience:

  • 3 years' experience preferred working in the areas of Quality, Data Outcomes, Process Improvement Projects, QI or QA activities within a healthcare entity

  • Knowledge of CMS regulations pertaining to Medicare and Medicaid preferred

  • Working knowledge of Microsoft Office, Excel Spreadsheets, portals and extensive knowledge of the components of medical records is required.

Certification/Licensure:  

  • MD or DO, Board Certification preferred

  • BLS

  • Active Florida Medical License required or has applied for a Florida license

Special Skills:  

  • Excellent reading comprehension and writing skills including spelling and grammar.

  • Statistical analysis skills for trending analysis and report.

  • Ability to communicate effectively with clinical as well as non-clinical staff and express the QI mission with all its operational details.

  • Communicate with a high degree of professionalism in both writing and speech; maintain professional demeanor and dress.

  • Maintain confidentiality of all clinical and corporate data.

Other requirements:   

  • Proficient in electronic health record system.

  • Able to work flexible hours as needed. 

  • Reliable transportation and current Florida Driver's license is required.

  • Travels to all CHC locations.