Director of Quality - The Brevard Health Alliance : Job Details

Come launch the next step in your career where America launched its Space Program. Brevard Health Alliance, Brevard County's only Federally Qualified Health Center, is currently recruiting for a Director of Quality to join us in the heart of Brevard County's Space Coast. Since 2005 our focus has been on putting the community in Community Health while delivering healthcare to more than 60,000 unique patients annually.Brevard Health Alliance offers competitive salaries, a comprehensive hiring package that includes Medical, Dental, Vision, Short and Long-term Disability Coverage and a 401K with company match, a generous personal leave program, a National Health Service Corps (NHSC) Approved Site for Loan Repayment and Qualified Employer for Public Service Loan Forgiveness, tuition assistance for continuing education, professional development, and the opportunity for upward mobility. We are expanding, we are growing. If you would like the genuine opportunity to make a profound difference in the delivery of primary care and community health, we invite your interest and application after reviewing the specifics and requirements for the Director of Quality listed below.POSITION SUMMARY To provide superior quality, competitive value, and outstanding service through the coordination and oversight of all quality functions, including reporting, data validation processes, and provider outreach and monitoring. Provides guidance for complex analytics and reporting in support of internal HEDIS, UDS, Medicare Star and NCQA accreditation. Operationalizes workflows to ensure collection of necessary quality data and metrics. Works in collaboration with the Quality Committee, Risk Committee and operations ensuring the highest level of care for BHA patients. The Director will lead efforts to improve quality outcomes and clinic efficiencies in a way that contributes to an enhanced experience for both staff and patients. The Director will play a central role in the clinic's goal to achieve and maintain Patient Centered Medical Home (PCMH) recognition and optimizing electronic health records (EHR) and other Health Information Technology. In conjunction with the Chief Quality Officer, the Director will lead and facilitate key process improvements in patient access measures, quality data, population-based quality improvement, and patient experience.GENERAL EDUCATION REQUIREMENTSA Bachelor's, Masters or Doctorate in Health Care Administration or other health care related field is preferred.5+ years of experience in healthcare management.ADDITIONAL QUALIFICATIONS/PRIMARY ACCOUNTABILITIES At minimum, 4 years of experience in managing clinical teams. At minimum, 2 years of STAR and/or HEDIS program experience Comprehensive knowledge of regulatory standards; including but not limited to: HEDIS, STARs, UDS, NCQA, HRSA, MACRA/MIPS and CMS. At least 3 years of experience with data analysis. Understanding and deep knowledge of the operations of a FQHC and PCMH standards. At least 5 years of healthcare-related experience. Supervisory and/or management experience preferred. Strong written and communication skills with the ability to write clear, structured, articulate, and persuasive improvement proposals. Problem solving skills, ability to collaborate, and proactive approach to work. Advanced experience using Microsoft office applications. Ability to operate and extract clinical workflow data from electronic medical records, preferable E-Clinical Works Ability to function through virtual communications, such as Microsoft Teams. Experience working within a constantly changing healthcare environment with quick adaptation skills.PRIMARY ACCOUNTABILITIES Knowledge of Medicaid and Medicare regulations for managed care. Ability to use data from electronic medical records, preferable eClinicalWorks Experience working in deadline-driven environments. Exhibits the ability to deal with difficult situations diplomatically. Possesses strong skills as a communicator and educator. Example of Ethical and Moral leadership. Supervises quality department manager, collaborates with the Clinical managers, Providers, Chief Medical Officer, Chief Operating Officer, and Chief Quality Officer to identify workflows creating productive quality outcomes. Develop, review and update policies, procedures, process improvement, training, and evaluation that help support efficient clinic workflows, productivity, quality improvement and customer service. Participate in the recruiting, hiring, and retention of staff as needed to support quality-centric patient care. Participate and provides leadership in Patient Centered Medical Home team and ensure effective implementation and maintenance of concepts, principles, and processes across the clinics. Facilitate and support process improvement initiatives that enhance Team Based Care and PCMH activities, and improved clinic flow. Maintain efficient patient care workflow through a team approach. Responsible for ensuring compliance with rules and regulations that impact clinic operations, including participation in audits and the development and implementation of Corrective Action Plans. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications, establishing, and maintaining personal networks; participating in professional societies. Collaborates with Executive Team Members and carries out other assigned tasks. Takes ownership and represents Brevard Health Alliance's mission and organizational goals established by the executive committee. Serves as a subject matter expert on HEDIS/UDS measures and the annual HEDIS/UDS process, as well as the Medicare Star program and annual rating process. Ensures all data sent to HEDIS software vendor are accurate and meet HEDIS reporting timeline. Participates as a member of appropriate committees and task forces assigned to improve quality, also reporting directly to the CQO. Serves as an active participant and key member of the Quality Committee, and helps the committee achieve set goals. Identifies, plans for, communicates, monitors, and evaluates actions to comply with existing and new regulations, standards, and accreditation requirements. Conducts timely analysis of regulatory materials (CMS Call Letters, HEDIS Technical Specifications, UDS, NCQA requirements, etc.). Leads direct interventions with members and providers to address gaps in care. Develops, in collaboration with other departments, informational and training materials for providers and members. Consults and assists in training staff on measurement specifications and requirements. Provides oversight to HEDIS reporting and abstraction vendors and is the in-house abstraction project lead. Leads the annual HEDIS/UDS review and serves as subject matter expert with other departments to ensure claims, utilization, pharmacy, and enrollment data provided to auditors and regulators is accurate and timely. Assists with third party audits and serves as subject matter expert on identification of trends, practices, and training needs that hinder quality performance. Analyzes quality rates for HEDIS/UDS, compares to established benchmarks, and identifies opportunities for process improvement in health plan quality. Analyzes data for possible data integrity and data deficits. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications, establishing, and maintaining personal networks; participating in professional societies. Collaborate with internal and external stakeholders to ensure HEDIS initiatives are fully integrated throughout the business unit, maximizing opportunity to improve outcomes for members.SUPERVISORY RESPONSIBILITIES Delegates tasks and responsibilities as needed for efficient workflows and capturing quality data. Participates in all appropriate meetings, including daily huddles. Evaluates associate performance and complete annual reviews and submits to Human Resources (HR) within 30 days of Associate's annual anniversary. Completes 90 Day Reviews and submit to HR within 1 day of associate review date. Ensure adherence to positive disciplinary action and submits to HR.