Director of Quality and Population Health

Description

GENERAL DESCRIPTION:

Reporting directly to the Chief Medical Officer, the Director of Quality and Population Health is responsible for leading and advancing population health outcomes and quality of care across Carolina Health Centers, Inc. This position serves as the official liaison between CHC and managed care companies as well as the accountable care organization (ACO), ensuring effective communication and collaboration. As a key member of the management team, the Director develops, implements, and evaluates strategies for population health, quality improvement, practice transformation, and digital health initiatives.

DUTIES AND RESPONSIBILITIES:

• Provide leadership and direction for the Department of Quality and Population Health, including supervision of staff responsible for care management, care coordination, analytics for managed care organizations, and addressing social drivers of health.
• Directly supervise the manager(s) of Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) programs, ensuring effective program implementation, integration, performance and revenue generation.
• Monitor and report on CCM and RPM program metrics (enrollment, engagement, clinical outcomes, reimbursement), preparing monthly, quarterly, and annual reports for leadership and the Quality Improvement Committee.
• Complete clinical reporting and analysis in compliance with the Quality Improvement Plan, grants, managed care organization agreements and federal requirements.
• Coordinate Peer Review program (quarterly) and Patient Satisfaction Surveys (annual).
• Lead and manage the Quality Improvement Committee, including managing roster, developing agenda, strategies for collaboration and improvement and PDSA cycles.
• Convene department and interdepartmental meetings for training, collaboration, and updates.
• Lead and/or support the Front Desk Foundations meetings.
• Work with managed care organizations and Community Integrated Management Services (CIMS) to facilitate population health goals, gaps in care coordination, HEDIS measure performance and accurate performance monitoring and incentive payments.
• Disseminate information from managed care organizations and strategize and help implement system improvements.
• Travel to sites, form relationships with staff (including providers), present data, educate on the meaning and importance of the information, and facilitate staff improvement methods.
• Organize and lead the Provider Enhancement Program (PEP) meetings to build comradery and knowledge within the provider staff.
• Chair the Patient Centered Medical Home (PCMH) Committee and coordinate PCMH applications, maintenance and audits.
• Collaborate with state and regional partnerships on population health, quality improvement, and health system innovation.

REPORTING RELATIONSHIPS:

Responsible to:

• Chief Medical Officer

Workers supervised:

• Case managers, Quality Improvement Specialists, Care Coordination Specialists, Population Health Specialists and CCM/RPM Program Manager(s)

Interrelationships:

• Works in cooperation with all types of staff and effectively serves customers

This job description is not designed to cover or contain an exhaustive list of activities, duties, or responsibilities. Duties, responsibilities, and activities may change at any time with or without notice

Requirements

 REQUIREMENTS:

All employees of Carolina Health Centers, Inc. are expected to perform the duties of their job and behave in a manner consistent with the Corporate Philosophy which supports the values of: honesty, integrity, openness, the pursuit of individual and collective excellence, and unwavering mutual respect and appreciation.

In addition, this position requires:

Education:

• Bachelor’s degree required, master’s degree in public health, healthcare administration, nursing, or related field preferred.

Work Experience:

• Minimum two years’ experience in healthcare, population health, quality improvement, or related field preferred.
• Experience implementing and overseeing Chronic Care Management and Remote Patient Monitoring programs strongly preferred.

Licensure and Credentials:

• None required; CPHQ, CCM, RHIA or similar certifications preferred.

Beneficial Attributes:

• Knowledge of population health, quality of care concepts, managed care organizations, billing and coding requirements, and social determinants of health.
• Critical thinking and data analysis skills.
• Computer proficiency, including EHR and reporting systems, Excel proficiency required.
• Organizational skills for managing long-term projects and rapid change processes.
• Professional demeanor and effective communication skills.
• Ability to navigate relationships and manage the inherent organizational stress between quantity and quality

Professional Abilities:

• Compile and analyze data
• Manage long-term projects
• Collaborate with staff and external partners across diverse settings
• Multitask across multiple projects, tasks and strategies

Physical Abilities:

• Able to push, pull, reach, sit, stoop, and stretch.
• Full range of body motion.
• Hand-eye coordination and manual dexterity for computer and office equipment.
• Required to talk and hear.
• Vision abilities for close, distance, color, peripheral, depth perception, and focus adjustment.
• Noise levels: quiet to moderate.

Work Environment:

• Exposure to patient/customer elements in a medical practice enforcing OSHA and HIPAA compliance.
• Professional office environment with standard office equipment.
• Periodic domestic or overnight travel may be required.