Director of Clinical Quality Outcomes

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 (QI)/quality assurance (QA) program
    • 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.  


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.