Director of Clinical Quality Outcomes - Administration

    Primary Responsibilities and Specific Duties:

    • Monitors industry trends, anticipates implications and opportunities and collaborates with the leadership team to develop, manage and communicate clinical quality initiatives including but not limited to HEIDS/Star program, PCMH and Meaningful Use.
    • Oversees the auditing process for Data Outcomes including identifying trends and articulates current performance in specific areas/indicators. Benchmarks performance against clinical industry standards.
    • Tracks and provides analysis of data that is understandable to different audiences, such as providers and staff, leaders, executive leadership, QIC and Board of Directors.
    • Participates on the Quality Improvement Committee (QIC).
        • In partnership with the QIC Committee, other departments and leaders, evaluates process for performance improvement. Develops, evaluates and implements policies and procedures, trainings to ensure continuous quality improvement processes.
        • Under the direction of the Chief Medical Officer (CMO) monitors the Quality Improvement plan.
        • In collaboration with the CMO, Chief of Quality, Finance, Informatics, Nursing and other departments, has the responsibility of directing, coordinating and monitoring the activities related to clinical quality initiatives.
        • Implements and facilitates cross-functional teams to complete projects or assignments.
        • Participates in periodic mock surveys to assess accreditation preparedness.

    • Serves as the organizations designated Medicare Compliance Lead to ensure compliance with all existing and emerging requirements related to CMS.
        • Advises the President/CEO and Executive Leadership team on emerging trends, methodologies or issues in coding, billing compliance or documentation issues

  • Participates on the Credentialing Committee.


Qualifications:

Education:

    • Minimum of a Bachelor's Degree in a Healthcare Related Field required.
    • Master's Degree of Healthcare Administration or Business Administration preferred.

Experience:

    • 3 years' experience working in the areas of Quality, Data Outcomes, Process Improvement Projects, QI or QA activities within a healthcare entity preferred.
    • Knowledge of CMS regulations pertaining to Medicare and Medicaid required.
    • Working knowledge of Microsoft Office and extensive knowledge of the components of medical records is required.

Certification/Licensure:

    • None

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.