Director of Quality Performance - Registered Nurse - Your Health Organization

GENERAL DESCRIPTION
The role of the Director of Quality Performance is a vital role responsible for overseeing the care team for the MDs and DOs of Your Health. This care team plays a crucial role in providing clinical oversight of Your Health patients. As a Value-Based healthcare provider, the roles primary objectives include ensuring accurate patient diagnoses, controlling healthcare costs, and optimizing the quality of care provided to patients. The Director of Quality Performance manages a team of primary care providers, clinical coordinators, social workers, and case managers to achieve these goals. The position will be responsible for staff productivity, ensuring the provision of quality care services and the reduction of unnecessary healthcare costs. The Director of Quality Performance will support a culture of compliance with all applicable federal and state regulations. This position works closely and collaboratively with the members of the care group and with regional leadership.
AREAS OF RESPONSIBILITY
A successful Director of Quality Performance will be able to perform these essential duties and responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.
The following is a list of essential functions, which may be subject to change at any time and without notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s).
Clinical Oversight
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Manage and provide clinical oversight for a team of MDs/DOs responsible for overseeing the care of approximately 800-1000 homebound patients.
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Ensure the accuracy and specificity of patient diagnoses to establish expectations for Medicare spending on patient care.
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Guide the interdisciplinary team in appropriate touchpoints with patients to reduce unnecessary healthcare utilization, including hospitalization, home health, and hospice stays.
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Collaborate with the care team to eliminate duplication and overutilization of healthcare services.
Team Management
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Lead and supervise a care team consisting of MD’s/DO’s, two clinical coordinators, a social worker, and a case manager.
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Foster a collaborative and patient-centric work environment that emphasizes quality, efficiency, and patient satisfaction.
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Provide mentorship, training, and support to team members to enhance their clinical capabilities, and performance.
Performance Measurement
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Implement and monitor productivity standards for the care team.
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Evaluate team members' performance based on productivity, accuracy of diagnoses, and cost-control efforts.
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Ensure accurate tracking of productivity in the CCM (Chronic Care Management) software, which includes time spent on various patient-related activities.
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Patient Care: Actively engage with patients to help them understand the Company’s care model, their diseases, and disease management strategies.
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Productivity Management: Monitor and enhance the productivity of your care team to ensure that all necessary assessments and patient visits are conducted efficiently.
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Service Recovery: Collaboration for conflict, complaint management and resolution for any concerns.
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Promote effective two-way communication between employees supervised, administration and team members within the region.
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Training and Supervision: Provide training and guidance to staff, ensuring they understand their job responsibilities, goals, protocols, customer service standards, and proper use of company’s software systems.
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Participate in interviews and hiring staff when necessary.
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Administrative Functions: Perform general administrative tasks and support other staff as needed.
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Leverage technology platforms to enhance patient care and staff productivity.
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Participate in coaching calls.
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Perform other duties as requested or required, in the sole discretion of the Company.
MISSION EXPECTATIONS
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Take responsibility for own work in completing tasks. Assist others so that the resources, assistance, or support is provided to achieve success in their daily work.
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Communicate, endorse, and demonstrate the Company’s mission, vision, and values.
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Prompt and regular attendance.
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Adhere to standards of behavior, dress code including name tag and approved uniform, personnel department, and company policies.
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Attend in-services and meetings on a regular basis.
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Promote a culture of outstanding customer service and strive to enhance patient experience at all times.
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Must be available during normal work hours (unless previously approved by direct supervisor). Additional hours may be required to complete normal business functions and/or projects.
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Must possess the ability to deal tactfully with patients, employees, management, visitors, government agencies, and the general public and maintain an open-door policy for all employees.
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Must possess the ability to make independent decisions when circumstances warrant.
WORK ENVIRONMENT
The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job:
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May be exposed to housekeeping cleaning agents and chemicals, humidity, hot equipment, and/or noise.
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May be exposed to infections, communicable diseases, odors, bloodborne pathogens, excreta, and hazardous materials.
COMPLIANCE WITH POLICIES AND PROCEDURES
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Comply with all federal, state, and local laws and regulations.
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Knowledge of and compliance with Patient’s Bill of Rights.
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Must be knowledgeable of Medicare guidelines, applicable laws and regulations, and the Company’s policies and procedures.
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Adhere to the Company’s Code of Conduct / Ethics.
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Must exercise a high degree of confidentiality regarding patients, personnel, and the company.
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HIPAA compliant.
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Promote a culture of compliance.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.
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Must be able to lift, reach, bend, push, pull, use repetitive hand motions, walk, and carry simultaneously.
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Must be able to withstand reaching, stooping, bending, kneeling, and crouching; walking and standing for periods of time; lifting up to fifty (50) pounds.
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Must be in good general health and demonstrate emotional stability.
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All employees of the Company are responsible for ensuring processes to monitor and evaluate compliance, quality, and risk management, as they pertain to policies and procedures and all related local, state, federal, and the Company’s standards, are upheld and followed. This is a daily ongoing requirement of the Company’s and will be adhered to. Any violations of these quality and compliance standards at any level will be promptly reported, reviewed, and acted upon in accordance with company directives. It is your duty as an employee to maintain these standards at all times.
QUALIFICATIONS
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Licensed nurse or equivalent healthcare qualifications required. Registered Nurse (RN) preferred.
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Associate’s Degree or Bachelor’s degree required.
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Strong leadership and team management skills.
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Excellent communication and patient engagement abilities.
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Knowledge of primary care billing and healthcare cost reduction strategies is a plus.
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Ability to read and communicate effectively.
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Strong written and verbal skills.
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Basic computer knowledge.
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Ability to manage and demonstrate effective leadership skills.
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Should demonstrate good interpersonal and communication skills under all conditions and circumstances.
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Ability to foster a cooperative work environment.
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Team player with ability to manage multiple responsibilities and demonstrate sound judgment.
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Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile that is insured in accordance with state and/or organizational requirements and is in good working order.
I have received, reviewed, and understand the requirements of this job, and agree that I can perform the requirements of this position. I accept the position and agree to perform in accordance with established policies and procedures, and all Federal, State, and local laws, regulations, codes and accepted professional standards and principles that apply. I understand that if I require a reasonable accommodation to perform any essential function of my job, I will clearly communicate that to Human Resources. Every effort has been made to make your job description as complete as possible. However, it in no way states or implies that these are the only duties you are required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar or is a logical assignment of the position, in the sole discretion of the Company. This job description does not constitute a contract of guaranteed employment for any period of time. I understand that my employment is at-will and that I can be terminated at any time, with or without notice or cause.
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