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Director of Quality Management, Redding or Fairfield, CA


Organization: Partnership HealthPlan of California
Category: Director
Location: Redding or Fairfield, CA
Date Job Posted: July 1, 2022
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Director of Quality Management **

Job Locations: US-CA-Redding or Fairfield
Job ID 2022-2281 FLSA Status Exempt

Overview

Under the direction of the Senior Director of Quality and Performance Improvement (QI/PI), the Director of Quality Management is responsible for directing plan-wide and regional performance improvement initiatives, quality incentive programs, and quality improvement data visualization tools and analyses. This includes, but is not limited to strategic goal setting, program planning, budget/account management, and supervision of teams.

Responsibilities

  • Direct PHC’s performance improvement activities, conducted by regional performance improvement teams and others in the quality department. Activities include large-scale network wide initiatives, DHCS mandated improvement projects, elective improvement projects conducted with internal and external partners, and initiatives specific to engaging members and improving member experience.
  • Assure ongoing prioritization, progress, evaluation, and monitoring of network wide and regional project portfolios to assure short term tactical plan objectives under the PHC 5- Star Quality Strategy are achieved. Direct knowledge management processes and inventories to inform multi-year intervention strategies in quality measure score improvement.
  • Ensures all interventions are measured for effectiveness and efficiency, with timely analysis and reporting. Assures initiatives and programs are evaluated at an appropriate frequency with comprehensive, data driven reporting, conclusions, and recommendations. Oversee the delivery and ongoing development of PHC’s Partnership Improvement Academy and its associated programs.
  • Direct PHC’s Primary Care, Hospital, Perinatal, Palliative, Enhanced Case Management, and Long Term Care Quality Incentive Programs, also known as Quality Improvement Programs (QIPs). The QIPs provide financial incentives, data, and technical assistance to our provider network for meeting performance improvement targets.
  • Research, develop strategies, and advise on QIP payment and incentive methodologies for enhancing existing programs to align with the PHC 5-Star Quality Strategy. Initiate new pay for performance programs, as needed.
  • Direct the maintenance and enhancement of PHC’s provider level quality data visualization and analysis program, the Partnership Quality Dashboard. Work closely with Quality Improvement Analysis team, other leadership across QI department and PHC as a whole on data and measurement related activities, including the QIPs, PHC Stars Dashboard, provider reporting tools, and internal dashboards and program evaluations.
  • Lead, develop, and coach the leadership of PHC’s Performance Improvement teams, quality incentive programs (QIPs), and Quality Improvement Analysis teams in the hiring, training, coaching, and support of staff.
  • Assure robust communication and ongoing collaboration is achieved with sponsors, stakeholders, leadership, staff, and external partners involved in performance improvement initiatives and project portfolios across the organization.
  • Stay informed on key developments in the quality improvement field that impact our provider network, including patient-centered medical home certification criteria, meaningful use, primary care transformation best practices, and quality reporting requirements.
  • Partner closely with the Director of Quality Measurement to strengthen communication, understanding, and decision-making in how changes to NCQA and DHCS measure sets inform performance improvement priorities, QIP measure development, and data visualization in Partnership Quality Dashboard (PQD).
  • Foster strong partnerships between QI, Health Analytics, IT, and Population Health to fulfill data collection, reporting, and dashboard needs in achieving QI/PI deliverables and related organizational goals, while addressing competing priorities and assuring good stewardship of technical resources.
  • Serve as a member of QI Department and Health Services Management Teams:
    • Support Senior Director in budget management, staffing decisions, and strategic and operational planning.
    • Serves as a key contributor to maintaining and advancing progress under PHC’s 5-Star Quality Strategy and corresponding tactical plans, work plans, and department goals.
    • Support development of direct reports and other department staff by establishing clear goals, expectation, and metrics on all projects.
    • Accept other responsibilities as determined by the needs of the QI department.
  • Other duties as assigned.

Qualifications

Education and Experience

Bachelor’s degree in applicable field required; Master’s degree in healthcare is strongly preferred. Formal certification in areas of professional expertise such as Lean Six-Sigma, IHI’s Improvement Advisor Program, and training in the Model for Improvement is desirable. Minimum of three (3) years management experience required. Experience should include managing multifaceted quality and performance improvement projects. Working knowledge of principles and techniques of effective management, including training and evaluation. In depth knowledge of Quality Improvement Methodologies.

Special Skills, Licenses and Certifications

Ability to lead and motivate teams in achieving superior performance while assuring professional development of staff. Superior communication skills, adaptability, openness to feedback and new ideas. Excellent project management skills, including project planning, resource allocation, and completion status tracking and reporting. Strong critical thinking and data analytic skills are required. Advanced data analytic skills in healthcare quality data are desired. In depth knowledge of improvement methodologies such as the Model for Improvement, Lean, Six Sigma. High level of proficiency in MS Word, Excel, Outlook, and Visio are minimum requirements. Proficiency in MS Project, Tableau, and reporting software desirable. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.

Performance Based Competencies

Strong written and oral communication skills. Excellent interpersonal skills to build relationships and communicate with the PHC provider network, various PHC regional offices, and other PHC departments. Ability to teach and coach diverse healthcare leadership and staff on quality management projects. Strong organizational skills to work on multiple projects simultaneously within established time frames. Strong analytic and critical thinking skills. Demonstrated skills in facilitation, consensus building, conflict resolution, and identification of concrete action steps.

Work Environment And Physical Demands

Must be able to work in a fast paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members. More than 50% of work time is spent in front of a computer monitor. When necessary, the ability to lift, carry, or move manuals and reports, weighing up to 25 lbs.

All HealthPlan employees are expected to:

  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

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