• Serves as TMPN’s organizational leader for clinical quality programs.
• Designs and leads quality improvement projects using Lean methodology, rapid improvement events, and evidence-based interventions.
• Standardize clinical workflows, SOPs, and care gap processes across all clinic locations to ensure consistent, high-quality execution
• Oversee performance dashboards, quality scorecards, and operational reporting that drive accountability at every level of the organization.
• Integrates quality measures into provider workflows, compensation models, and patient experience initiatives.
• Partners with IT, clinic operations, and scheduling to align access and throughput with quality and care delivery goals.
• Leads HCC/RAF optimization and HEDIS performance improvement across TMPN’s Medicare Advantage and risk-based populations.
• Drives CMS Star Rating strategy and manage health plan quality relationships.
• Oversee care gap closure initiatives, risk stratification programs, and population-level outreach campaigns.
• Monitors and responds to CMS, NCQA, and regulatory changes across quality and risk adjustment programs.
• Builds, develops, and retains a high-performing team across clinical performance, quality, and operations.
• Serves as a trusted partner and liaison between TMPN operations, physician leadership, and health plan partners.
• Presents performance results and strategic recommendations to senior leadership and medical staff committees.
• Promotes a culture of continuous improvement, data-driven decision-making, and accountability across the network.
• Bachelor’s degree required. Master’s degree preferred (MBA, MPH, MHA).
• 7 + years of progressive experience in clinical quality, population health, or value-based care operations;
• 5 + years of people leadership experience required.
• Demonstrates expertise in HEDIS measures, CMS Star Ratings, and HCC/RAF optimization
• Experience in physician practice, ambulatory care, or medical group operations.
• Strong understanding of CMS quality programs, NCQA HEDIS specifications, and risk adjustment models
• Strong analytics capabilities, including experience with EMR reporting, BI platforms, and population health data tools
• Operations experience, including Lean/A3 methodology, SOP development, and workflow standardization
• Exceptional communication and relationship-building skills across clinical, operational, and executive audiences
Salary Range: $142,438.00 - $210,000.00
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