Clinical Quality Manager

Clinical Quality Manager

The Clinical Quality Manager is responsible for oversight of day-to-day activities of the Quality Department to ensure quality initiatives, CQI activities and other requirements of health center quality are met. The Clinical Quality Manager must be a strong advocate and champion for the elements of the Patient Centered Medical Home. The Clinical Quality Manager must support the Director of Clinical Quality in quality performance activities to ensure quality patient care.

Essential Duties and Responsibilities:

• Leadership and Operations
• Reporting to the Director of Clinical Quality, the Clinical Quality Manager supports the quality team. This includes Case Managers and Wellness Nurses. The Clinical Quality Manager coordinates quality improvement activities and collaboratives to improve clinical quality/performance.
• Analyzes quality gaps within the organization, evaluates solutions, utilizes best practice guidelines to guide quality improvement activities.
• Supports hiring, evaluates, trains, and supervises the quality coordinator, case managers and wellness Nurses.
• Supports a team approach to quality solutions within the organization.
• Externally, participates in quality collaboratives that support improvements in overall patient outcomes.
• Works collaboratively with the Manager of Clinical Support and the Non-Clinical Support Manager to support quality patient care.
• Maintains communication with all quality team members as well as other department leaders/directors to ensure understanding of quality initiatives, UDS and PCMH requirements.
• Use nationally recognized population health methodologies to assist with development of annual quality plan.
• Collect and coordinates data for PCMH submission.
• Collaborates with the Director of Payer Relations and others on payer related quality measures to include HEDIS, ACO, CIN and any other activities and reporting.
• Financial Management
• Works closely with the Director of Clinical Quality in forecasting and preparing annual budget.
• Helps evaluate financial decisions that affect quality initiative and incentive within the organization.
• Ability to understand the elements of the Performance Management Incentive Bonus Plan as it relates to scorecard calculations, NACHC percentages and program requirements.
• Human Resources and Team Development
• Resolves department problems and openly communicates with quality staff to ensure high productivity and morale.
• Ensures that Leader Rounding activities occur regularly to ensure leader visibility and improve staff relations.
• Manages a quality team that includes care coordination and case management.
• Manages Performance Evaluation and staff relations for the Quality Team.
• Works closely with Human Resources in maintaining Employee Health issues including but not limited to immunizations and vaccinations.
• Compliance, Quality and Performance Improvement
• Participates in maintaining organizational compliance with governmental regulations and industry requirements.
• Supports activities to maintain such compliance.
• Coordinates and leads quality improvement performance programs.
• Supports and participates in organizational risk management and corporate compliance programs.
• Assists with UDS tracking of quality metrics and performance improvement activities.
• Manages/tracks patient complaints.
• Supports team-based preparation for HRSA OSV reviews, review preparation, coordinating and follow-up.
• Maintains an understanding of Federal, State, and local laws and regulations that impact Grace Health's ability to provide patient care.
• Performs other related duties as assigned by the Director of Clinical Quality and the Chief Medical Officer.
• Communication:
  Conveys information accurately and efficiently. Written communication is direct, concise, and easy to understand.
• Decision-making:
  Gathers necessary information to make good and timely decisions. Uses sound judgment and instincts. Seeks direction from Leadership appropriately.
• Supporting/Assisting:
  Seeks opportunities to help others be successful in meeting goals. Demonstrates behaviors reflective of our mission when helping others.
• Planning/Priority setting:
  Organizes tasks and objectives in order of importance, timing, and predicted results. Works within measurable goals and outcomes.
• Problem solving:
  Works systematically to solve problems. Develops reasonable and timely resolutions.
• Initiative:
  Takes prompt action to accomplish objectives. Seeks to resolve problems without being asked. Seeks direction from Leadership…