• Director, Clinical Quality Improvement

    Posted Date 3 days ago(4/18/2019 1:55 PM)
    Job ID
    2018-5323
    # of Openings
    1
    Category
    Operations
    Type
    Full Time Regular
  • Overview

    Quality Improvement Director (Clinical License Required)

     

    Matrix Medical Network is the leading provider of in-home, facility, community based care management services revolutionizing health-care solutions. Founded in 2001 and headquartered in Scottsdale, Arizona, with regional offices in Largo and Orlando Florida. Matrix has a national clinical organization which provides high-touch, in-home care to help health plans balance cost and revenue, grow membership and improve the quality of care. After nearly doubling in size in recent years, Matrix continues to be well positioned for continued expansion. 

     

    Social Media_corporate 8 for iCIMS

    Matrix Medical Network seeks a Dir, Clinical Quality Improvement to serves as the strategic leader to the Quality organization reporting to the Vice President of Quality & Business Operations. In this highly visible role, the Dir, Clinical Quality Improvement is responsible for helping define and implement the performance monitoring and improvement strategy, goals and objectives of the organization. The primary focus shall be on overall clinical quality audits of evaluations while driving continuous efforts to meet and exceed industry standards. This position will also assist in developing, implementing, driving and championing methods to enhance the delivery of our clinical products and services to the members and clients we support. The leader will also work with the Quality Improvement team, to t provide coaching and support across multiple operational units. As a key clinical leader of the business, this individual will play an important role in working to further develop and implement our future products and services. This business leader will collaborate and work synergistically with other departments across our organizations, ensuring our processes and execution impact the delivery of quality services.

    Responsibilities

    • Collaborate with clinical & operational team members, cross-functional leadership and other key business areas in the development of organizational strategy, key initiatives, goals and objectives
    • As the key strategic clinical leader and as the change agent for the clinical quality organization, work with key business areas to optimize organization effectiveness, support business development activities and support our client services teams
    • Ensure the processes and clinical quality operations support we provide are meeting all healthcare compliance standards and act as a trusted advisor to the organization and the clinical industry
    • Drive continuous process improvement through Lean 6Sigma or other similar tools.  Review data analysis of productivity and quality works with leadership to implement changes or improvements in organization, staffing, work methods, and/or procedures.
    • Research and investigate new or improved revenue enhancement practices for clinical services and quality and assists with the development of business plans and ROIs in support of the idea(s)
    • Ensure that appropriate policies and protocols are in place so that quality measures are being met and delivered
    • Provide leadership, coaching and mentorship to the Quality Improvement teams across multiple organizations; with the goal of improving clinical quality results and data captured, enabling our clients to have a comprehensive assessment of their members’ health conditions
    • Create a work environment that embraces continuous improvement and an engaged and empowered workforce which may include Physician Assistants, Nurse Practitioners, Registered Nurses, and Certified Coders
    • Provide collaboration and support to the Clinical Services and Clinical Training Team, ensuring that providers have the necessary and timely quality feedback in order to improve healthcare outcomes for the population they serve
    • On an ongoing basis, in partnership with Director of Coding & Compliance, CMO and SVP of Clinical services, evaluate the Quality Improvement teams’ effectiveness and implement performance metrics in order to ensure the desired program outcomes/goals are attained
    • Interface with and drive alignment among operational departments (Clinical Operations, Clinical Services, Operational Excellence, Coding, and Education)

    Qualifications

    Education Requirements

    • Bachelor of Science in Nursing preferred
    • Masters of Doctorate Degree required or commensurate experience and satisfactory completion of NP licensure
    • Certified Professional of Health Care Quality (CPHQ)

    Licensure/ Certifications

    • Current NP or MD/DO licensure in state of practice
    • Board certifications by AANP or ANCC, in Adult, Family Practice and Geriatrics or Adult-Gerontology

    Required Skills and Abilities

    • 5-7+ years of healthcare experience, 5+ years leadership experience
    • Knowledge of NCQA, URAC, HEDIS, STAR and quality improvement regulations
    • Knowledge of Medicare and Medicaid guidelines
    • Exceptional verbal and written communication skills
    • Demonstrated proficiency with Microsoft Office suite
    • Strong analytical and problem solving skills
    • Proficiency with productivity monitoring and implementation
    • Excellent interpersonal skills, with the proven ability to lead, guide, and influence peers in a fast-paced and complex business environment
    • Ability and willingness to lead by example with production, quality, business ethics, and work habits
    • Strong business acumen focused on maximizing business and financial results
    • Strong demonstrated knowledge in the application of performance improvement/Kaizen/Lean /Six Sigma preferred

     

    SUCCESS FACTORS

     

    • Strong clinical background with a sound understanding of an evidence based clinical outcome
    • Able to work collaboratively within and outside the organization
    • Strong emotional intelligence competencies
    • Functional and technical knowledge to competently perform all aspects of the position
    • Demonstrated ability to effectively prioritize based on the needs of organization
    • Demonstrated results designing practices, processes and procedures which have positively impacted people and results, while managing from a distance
    • Action-oriented
    • Able to build a positive culture
    • Leadership competencies which enable the creation of an environment based on mutual respect, transparent communication, accountability and a sense of belonging to the team
    • Able to assesses talent by identifying strengths and opportunities, then developing others to reach new heights of performance

     

     

    Supervisory ResponsibilityMay have direct supervisory responsibilities, as well as indirect oversight of other Quality Operations processes.

     

    Travel Requirements:  10-20% travel may be required

     

     

    Work Conditions: General office environment.

     

    The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification.  Management reserves the right to add, modify, change or rescind the work assignments of this position.  Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of the position.

     

    Clinical Quality Improvement Director is based in our Scottsdale: 9201 E Mountain View Road, Suite 220 Scottsdale, AZ 85258. Matrix Medical Network partners with leading health plans and providers across the country.  Primary Location: Scottsdale-Arizona Work Locations: 9201 E Mountain View Road, Suite 220 Scottsdale, AZ 85258 Job: Clinical Quality Improvement Director Schedule: Regular Shift: Standard Employee Status: Leader: Full-time Job Level: Day Job Primary Location-United States 9201 E Mountain View Road, Suite 220 Scottsdale, AZ 85258 Hours: Monday - Friday 8AM - 5PM. No on-call, evening or weekend hours. Clinical Quality Improvement Director, Schedule, Full-Time,  Regular, Job Type, Standard, Travel, Pay, Hours

     

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed

    Get job recommendations

    Tell us a little about yourself, and we’ll recommend jobs that match your interests and experience. Click here to get started.