DaVita Director Clinical Quality in ALBUQUERQUE, New Mexico

Director Clinical Quality

Description

DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Nevada, New Mexico, Florida, Colorado and Washington in its pursuit to deliver excellent-quality health care in a dignified and compassionate manner. As of June 30, 2016 DaVita Medical Group (formerly HealthCare Partners) provided integrated care management for approximately 760,000 patients. DaVita Medical Group’s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.

We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all.

If you're looking to make a difference with a large, financially stable, well-recognized medical group, DaVita Medical Group may be the employer for you.

Overview:

Directs the overallquality program for ABQ Health Partners, (ABQHP). Responsible for the analysis of the qualityof care received by ABQ HP patients and for development of plans and programsto support continuous quality improvement within ABQ HP facilities. Manages allQuality Programs and departmental staff to ensure that ABQ HP’s strategicinitiatives of quality care and services are met. Responsible for theday-to-day operations of the Quality Program and Peer Review Programs. Participates in or provides direction in thedevelopment and implementation of quality improvement studies and improvingclinical and/or service outcomes. Interfaces with health plans, Managed Care department or other entitiesto ensure regulatory requirements pertaining to quality improvement activitiesare met. Adheres to policies, procedures and regulations to ensure compliance andpatient safety. Participation in Compliance and other important trainingis a condition of employment.

Essential Functions:

  • 1.Managesdaily operations of the Quality department and all Quality related programs andassigned staff, providing oversight and guidance in delivery of processimprovement initiatives and goals.2.Motivatesand leads all assigned Quality related departments in setting and reachingdepartmental goals. Creates anenvironment where improvement ideas, team-building and creative thinking areencouraged to meet the organization’s needs for process improvement.3.Responsiblefor clinical quality measurement, providing analysis and reporting of qualitymeasures to Executive Management Team within ABQ HP, parent organizations andto contracted entities such as health plans, in accordance with contracts,regulations or internal standards as applicable.4.Responsiblefor understanding the structure of the clinical data warehouse, providingoversight to decision support and IT teams responsible for creating thesereports and ensuring the capture and analysis of relevant criteria. This includes identifying any data gaps andstrengths, and deconstructing report data into the specific actions that can betaken by providers and staff to improve outcomes in the areas being measured,especially in relation to national, quality measurement criteria.5.Worksas a cross-functional team member with physicians, peers and others throughoutthe organization to ensure the delivery of quality care and services. Participates and supports all organizationalcommittees that are responsible for Risk Management, Quality, eHR decisionsupport, Quality of Care and Peer Review, ensuring identification of qualityimprovement opportunities and the implementationof improvement activities.6.Worksin collaboration with Clinical Management in grievance investigations andresolutions, quality initiatives and Peer Review activities, quality studies,credentialing, central Quality database and other related activities.7.Performsinternal and external clinical quality reporting to provide Clinicians withtransparent, actionable data with which to comply. Reviews and evaluates NCQA, (National Centeron Quality Assurance), CMS, (Center for Medicaid/Medicare Services), ManagedCare department and any other regulatory quality improvement requirements toensure ABQ HP meets these standards.8.Reviews,revises and amends the Quality Program at least annually as applicable.9.Identifies, developsand oversees the educational needs of all Quality Department staff, providersand others in the area of quality improvement.

Qualifications

Education:

  • Minimum: Bachelor's degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college

  • Preferred: Mater's Degree, MBA

Experience:

  • Minimum: Over 7 years and up to including 10 years of management experience

  • Preferred: Over 10 years of management experience

Knowledge, Skills, and Abilities:

  • Computer literate

  • Working knowledge of Microsoft applications (Word, Excel, PowerPoint)

  • Knowledge of medical billing and office automation software

  • Excellent verbal and written communication skills

  • Interviewing and interpersonal skills

DaVita Medical Group is an equal opportunity/affirmative action employer. As such, DaVita Medical Group makes hiring decisions solely on the basis of qualifications and experience, and without regard to age, race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.

We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.

DaVita Medical Group will consider qualified applicants who have criminal histories in a manner consistent with the law.

Primary Location NM-ALBUQUERQUE - 87102

Req ID: 314269