Director of Quality Management

Job Summary

Under the direction of the Chief Medical Officer, the Director of Quality Management is responsible for leading and directing process improvement activities that produce better patient care, address disparities, lead to appropriate utilization, and reduced costs of care. The Director interacts with payor partners and contributes to advancing value-based contracts and performance in a risk-based environment. Additionally, the Director manages a team that will work in collaboration with clinical and operations staff on varying initiatives including but not limited to quality improvement, reporting, clinical informatics, grant work and survey readiness.

Responsibilities

• Oversees and directs clinical quality improvement and is responsible for achievement of improved clinical outcomes which address healthcare disparities.
• Supports the development and implementation of population health and quality development strategic plan initiatives.
• Analyses pertinent data to inform recommendations for process improvement.
• Leads the Quality Improvement team and assists the Clinical Directors with development and implementation of quality improvement activities across specialties.
• Leads the Quality Improvement team in value-based contract performance across multiple payor groups and varying contracts focused on gap closure, hierarchical condition category coding and HEDIS measures.
• Assures collaboration within the department as well as across all service lines to promote ongoing improvement processes.
• Coordinates survey activities to assure that the facility maintains accreditation and certification, as necessary.
• Facilitates clinical data management and addresses the reporting needs of leadership including monthly reports, dashboards, grant-supported work, federal reports, and value-based monitoring.
• Develops strategies and protocols to support a successful care management program and programming that advances the organization in value-based contracts.
• Ensures all legal, regulatory and agency standards of care are met.
• Leads and motivates a high-performance team
• Furthers a culture of continuous improvement through ongoing training and development of all staff
• Contributes and directs pertinent funding activities, including grants at federal, state, and county levels
• Participates in agency committees and meetings, including the Leadership Team, as appropriate
• Works effectively on a team and communicates respectfully with patients and all staff based on shared goals and mutual respect. This includes demonstrating adaptability to continuous efforts to improve patient care and willingness to be an active care team member engaged in ongoing process and quality improvement projects within the framework of the Patient-Centered Medical Home.
• Honors patients' right to privacy and confidentiality. Adheres to strict patient, customer and business confidentiality standards.
• Completes special projects/duties as assigned

Complexity of Work

Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws and regulations.

Responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; resolving problems and addressing complaints.

Core Competencies

1. Accountability and Getting Results
2. Building Trust
3. Communicating (Written and Oral)
4. Continual Learning
5. Initiative
6. Interpersonal Skills
7. Maintaining Personal Credibility and Meeting Ethical Standards
8. Solving Problems
9. Technology Use/Management
10. Valuing and Leveraging Diversity and Inclusion

Minimum Qualifications

Required Qualifications:

1. Bachelor's Degree of Nursing, RN, or degree in another health-related field with relatable experience in quality improvement, population health and value-based programming.
2. Three years of management experience required.
3. Valid Wisconsin state license, as applicable.

Preferred Qualifications:

1. Master's degree and/or Quality Improvement certifications preferred.
2. Five years of leadership and management experience preferred.
3. Prior work experience and performance in value-based programming and population health.
4. Prior work experience in a Federally Qualified Health Center with a diverse patient population

It is mandatory that all employees, employed providers and volunteers are vaccinated. All hired candidates must submit proof of vaccination prior to their orientation. This is a mandatory requirement for Progressive Community Health Centers. The purpose is to minimize exposure to and transmission of COVID-19 and the influenza virus in the workplace by providing occupational protection to employees and thereby preventing exposure to members of the community, which we serve.

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