Manager Clinical Quality

JOB SUMMARY

The Manager of Clinical Quality is responsible for the operational implementation, coordination, and monitoring of clinical quality and performance improvement initiatives across Memorial Medical Associates. Under the direction of the Director of Quality and Value Based Care, the Manager translates organizational quality and value-based care strategies into practice workflows, improvement initiatives, provider and staff engagement, and measurable performance improvement. The Manager partners with providers, practice leaders, clinical staff, and organizational teams to support reliable execution of quality programs, close performance gaps, and advance evidence-based patient and family centered care. Strives for superior performance by consistently providing a product or service to leadership and staff that is recognized as ultimately contributing to the patient and family experience. Recognizes and demonstrates understanding of patient and family centered care.

JOB RESPONSIBILITIES

Quality Program Leadership

1. Manages the day-to-day implementation and coordination of ambulatory clinical quality and performance improvement initiatives in alignment with priorities established by the Director of Quality and Value Based Care.
2. Leads practice level performance improvement activities by partnering with providers and practice teams to identify barriers, develop and implement interventions, standardize workflows, and monitor progress toward sustained improvement.
3. Provides education and support to providers and office staff regarding quality measures, documentation requirements, care-gap workflows, and performance improvement opportunities.

Provider Engagement and Performance Management

4. Supports provider and practice level quality performance management, including scorecards data interpretation, identification of performance drivers, and development and follow up of improvement plans.

Population Health and Care Management

5. Coordinates care gap closure activities, including identification of eligible populations, outreach strategies, point of care workflows, and follow up with practices to improve measure performance.

Data, Analytics, and Reporting

6. Monitors and analyzes clinical quality performance including HEDIS, MIPS/Quality Payment Program, payer specific measures, and organizational quality priorities to identify trends, variation, care gaps, and opportunities for improvement, develop actionable reports and communicates findings to the Director, providers, and practice leaders.
7. Coordinates and monitors assigned quality reporting activities to support accurate and timely data collection, validation, submission and compliance with applicable reporting requirements and deadlines.
8. Identifies and investigates quality data discrepancies and collaborates with appropriate stakeholders, including Information Services, payers, and office teams, to support data integrity and accurate performance reporting.

Regulatory Compliance and Governance

9. Maintains current knowledge of applicable regulatory, payer, and quality program requirements and supports implementation of changes to workflows, processes, and reporting requirements.
10. Monitors compliance with assigned quality reporting requirements, documentation standards, deadlines, and audit activities and escalates identified risks or barriers as appropriate.
11. Adheres to and contributes to the development, review, and implementation of applicable policies and procedures.

General

12. Adheres to and contributes to the development of policies and procedures.
13. Maintains confidentiality of patient information and ensures patient's right to privacy.
14. Demonstrates flexibility in response to unexpected changes in work volume, staffing and scheduling.
15. Demonstrates professional conduct and communicates in a professional manner with patients, physicians, office employees and other hospital personnel.
16. Demonstrates commitment to patient safety and supports identification and mitigation of risks that may contribute to adverse patient outcomes.
17. Demonstrates knowledge of and support of Memorial Healthcare mission, vision and value statements, standards, policies, procedures, operating instructions, confidentiality statements, corporate compliance plan, and Standards of Behavior.
18. Participates in organizational and departmental strategic planning and supports implementation of applicable strategic initiatives.
19. Participates in annual planning and budget development for assigned areas and supports responsible utilization of departmental resources.
20. Leads assigned staff, including participation in recruitment, onboarding, education, competency development, engagement, performance management, and disciplinary processes in accordance with organizational politics.
21. Participates on committees as assigned.
22. Performs other duties as assigned.

JOB SPECIFICATIONS

EDUCATION

1. Bachelor's degree in Healthcare Administration, Public Health, Health Sciences, or a related field required.
2. Master's degree in Healthcare Administration, Public Health, Business Administration, or related field preferred.

EXPERIENCE

1. Minimum of three (3) years of experience in healthcare quality, performance improvement, population health, or related healthcare field required; ambulatory or physician practice experience preferred.  
2. Previous management or supervisory experience required; minimum of three (3) years preferred.
3. Knowledge of ambulatory quality programs and measures, including HEDIS, MIPS/Quality Payment Program, Patient Centered Medical Home, and value-based care quality initiatives preferred.
4. Knowledge of the basic principles of management and supervision, including human resources management, performance improvement, information technology, departmental planning, service programming, budget, staffing and other appropriate leadership skills is required.
5. Training or experience in performance improvement methodologies (e.g., LEAN, Six Sigma, PDSA) with good understanding of data analysis and quality measurement preferred.
6. Experience in leading performance improvement initiatives and collaborating with providers and interdisciplinary teams to improve clinical quality outcomes preferred.
7. Skilled in developing scorecards, dashboards, and performance reports that translate complex data into clear action; familiarity with and ability to operate Microsoft Office applications required.

CERTIFICATIONS AND LICENSURE

1. CPHQ (Certified Professional in Healthcare Quality) or other relevant quality, performance improvement, or population health certification preferred.

ESSENTIAL MENTAL ABILITIES

1. Ability to work under stressful conditions associated with interruptions and deadlines.
2. Ability to assess problems and resolve questions logically, accurately, intelligently, and in a timely manner.
3. Ability to maintain a professional demeanor at all times, physically, verbally, and in all written communication.

ESSENTIAL PHYSICAL REQUIREMENTS, TECHNICAL/MOTOR SKILLS

These physical requirements are not exhaustive and additional job-related physical requirements may be added on an as needed basis. Corrective devices may be used to meet physical requirements.

1. Sedentary Work: Frequently required to stand, kneel, and crouch. On a daily basis may be required to move about, sit, climb stairs and bend. Is frequently required to lift and carry up to 20 lbs. May be required to push/pull/carry items between 20-100 lbs. Regular travel across medical group practice sites is required.
2. Vision: Requires the ability to perceive the nature of objects by the eye. Near acuity: Clarity of vision at 20 inches or less. Midrange Acuity: Clarity of vision at distances of more than 20 inches and less than 20 feet.
3. Motor Coordination: While performing the duties of the job, it is required to regularly perform functions that include using hand and finger movement, handle or feel objects, be able to use tools or equipment that requires reaching with hands and arms. Must be able to travel independently throughout the hospital and practice sites; access patients/families including areas confined by space and/or equipment.
4. Speaking/Hearing: Ability to give and receive information through speaking and listening.

ESSENTIAL TECHNICAL ABILITIES

1. Proficiency using modern office, computer and telephone equipment as used by Memorial Healthcare.

ESSENTIAL MENTAL ABILITIES

1. Ability to adapt and maintain focus in fast paced, quickly changing or stressful situations.
2. Ability to read and interpret a variety of documents including, but not limited to policies, operating instructions, white papers, regulations, rules, and laws.

ESSENTIAL SENSORY REQUIREMENTS

1. Able to see for the purpose of reading information received in formats including but not limited to paper, computer, reports, bulletins, updates, manuals.
2. Able to hear for work-related purposes.

INTERPERSONAL SKILLS

1. Ability to interact with co-workers, hospital staff, administration, patients, physicians, the public and all internal and external customers in a professional and effective, courteous, and tactful manner, at all times, physically, verbally and in all written and electronic communication.
2. Required to remain calm when adversity is encountered.
3. Open, honest, and tactful communication skills.
4. Ability to work as a team member in all activities.
5. Positive, cooperative, and motivated attitude.
6. Proven ability to build credibility and drive behavior change with physicians and advanced practice providers.
7. Excellent written and verbal communication skills, including experience presenting to executive leadership and board committees.
8. Collaborative, relationship-driven leadership style suited to a matrixed organization with multiple stakeholders.