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.
Minimum of a Bachelor's Degree in a Healthcare Related Field required.
Master's Degree of Healthcare Administration or Business Administration preferred.
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.
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.
Proficient in electronic health record system.
Able to work flexible hours as needed.
Reliable transportation and current Florida Driver's license is required.