Director, HCC Programs & Clinical Quality
Director, HCC Programs & Clinical Quality

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Job Overview

Company: HealthCare Partners Medical Group
Location: Phoenix, AZ (map it!Map it!)
Base Pay: N/A
Employee Type: Full-Time
Industry: Healthcare - Health Services
Manages Others: Not Specified
Job Type: Health Care
Req'd Experience: Not Specified
Req'd Travel: Not Specified
Relocation Covered: Not Specified
Contact: Not Available
Phone: Not Available
Email: Not Available
Fax: Not Available
Ref ID: 14644


We invite you to explore career opportunities at HealthCare Partners. Join us and you will have the chance to live our vision while working with an outstanding team of professionals who excel in the healing arts.

Job Summary

Director, HCC Programs & Clinical Quality

Department: HCC Activities

Shift: Days

Hours: m-f 8-5 pm

Bachelor's Degree
More than 5 years of experience required

HEALTHCARE PARTNERS MEDICAL GROUP, a division of DaVita HealthCare Partners, Inc. (DVA: NYSE), is a top-rated Southern-California medical group and is widely recognized for its achievements in clinical excellence and patient satisfaction. Since 1992, HealthCare Partners has been committed to developing innovative models of healthcare delivery that improve patients' quality of life while containing healthcare costs. HealthCare Partners manages and operates medical groups and affiliated physician networks in Arizona, California, Nevada, Florida and New Mexico. As of Sept. 30, 2013, HealthCare Partners provides integrated care management for approximately 760,000 managed care patients.  - Read More -

We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all.

If you're looking to make a difference with a large, financially stable, well-recognized medical group, DaVita HealthCare Partners may be the employer for you.

HealthCare Partners may be the employer for you. As part of our continued growth we have immediate opportunity for Director, HCC Programs. This key leadership role will be responsible for administration and oversight of the development, implementation, operations and analytical activities related to the Medicare HCC and Star programs.  Our HCC programs are designed to facilitate comprehensive and coordinated care and proper payment.

Leads development and implementation of programs designed to both appropriately capture all patient’s diagnoses, and assure appropriate documentation in the patient chart/HER.  Coordinates implementation of HCC and Star quality programs including, but not limited to training and educational activities, process development and improvement, audits and reporting.  Coordinates with clinician leadership to ensure the clinical aspects of HCC and Clinical Quality programs and best practices are communicated to group and IPA providers.  Oversees clinician chart audit activities and coordinates operational aspects of clinical chart reviews, including identifying and data mining patient lists, coordinating chart acquisition with reviewers, communicating results to rendering physicians and tracking and analyzing findings.  Oversees preparation and implementation of clinical correlation and clinical quality studies.  Works with Clinical Informatics Analyst to prioritize studies and provide analytical support.  Functions as primary content owner of technical and analytic tools utilized to perform HCC and Medicare Star research and analysis activities.  Interfaces with operational market and national leadership to identify and implement operational and clinical best practices in optimizing HCC operations.  Assists in the design of incentive and reimbursement programs for group and IPA constituents to incentivize appropriate coding and documentation practices related to HCC activity and clinical quality.  Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. Performs additional duties as assigned. 

Director, HCC Programs & Clinical Quality 

Job Requirements

Bachelor's degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college. MHA or MBA preferred.  Minimum  7 – 10 years and up to and including 10 years of experience in a healthcare setting including minimum 3+ years of supervisory experience.  Experience in analytics and data analysis.  Background in supporting HCC activities and clinical informatics, experience  in supporting HEDIS clinical quality and Medicare Star activities. Expertise in Microsoft applications.  Fluency in database applications, such as MS Access and SQL. Mastery in outcomes analysis and reporting. Computer literate. Excellent analytical and problem-solving skills.  Excellent project management skills.  Excellent communication skills.  Ability to effectively direct preparation of various financial analysis and data mining activities. Excellent verbal and written communication skills.  Ability to effectively interface with staff, clinicians and management.



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