Senior Director of Quality & Performance Improvement

Overview The Senior Director of Quality and Performance Improvement is a key individual on PHC’s Senior Leadership Team and is responsible for leading a growing Quality Department at Partnership HealthPlan of California (PHC) through quality and performance improvement activities to substantially improve the quality of care provided to PHC members. Responsibilities • In collaboration with the CMO, lead the strategic direction of PHC’s quality initiatives organization-wide, including prioritization of efforts. • Lead, develop, and coach the Quality and Performance Improvement staff including staff hiring, training, performance appraisals, goal setting, and resource allocation. Assess overall performance using internal and external feedback mechanisms to actively optimize capacity within the department while leveraging individual strengths and nurturing career development plans. • Manage the Quality and Performance Improvement budget. • Oversee PHC’s quality improvement program, ensuring all interventions are measured for effectiveness and efficiency, complete annual review and update of the program, and write annual plan. • In collaboration with the CMO and CFO, oversee the administration of PHC’s pay for performance programs. • Oversee performance improvement activities conducted by the quality department, including PHC’s Partnership Improvement Academy, DCHS mandated improvement work, performance improvement and engagement activities done with the PHC network. • Oversee Quality department activities key to the success of inter-departmental quality initiatives and the achievement of organization-wide quality goals. • Oversee PHC’s provider level quality data visualization and analysis program, the Partnership Quality Dashboard. • Oversee the monitoring and improvement activities surrounding PHC’s “Internal Quality Dashboard” also known as the PHC Stars, to evaluate and monitor the quality of care provided to PHC members. • Prepare the organization for quality and performance improvement review, survey, and accreditation processes by external monitoring agencies, such as DHCS, DMHC, CMS, or NCQA. • Oversee the optimization of monitoring systems for collection and reporting of HEDIS data, including the statewide improvement projects aimed at improving performance in HEDIS measures. • Oversee the Facility Site Review/Medical Record review to ensure that all regulatory and accreditation requirements are met within required timeframes and that results are coordinated with the peer review/credentialing/re-credentialing process. Secondary Duties and Responsibilities • Present project updates and results to PHC’s leadership team, internal improvement committees, physician committees, and PHC’s Board of Commissioners as appropriate. • Oversee the coordination of QI activities and data collection for PHC’s contracted medical groups and providers. • Organize and prepare all materials and serve as staff resource for assigned PHC committees. • Work with assigned committees to identify barriers and design intervention strategies for quality and performance improvement. • Write, review, and seek approval for policies and procedures, ensuring that both the departmental and organizational needs are met. • Participate in special projects and assignments as required. Qualifications Education and Experience Bachelor’s degree in applicable field required; Master’s degree 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 five (5) years management experience in a medium to large size organization. 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. Grant writing and grant management experience is desirable. Special Skills, Licenses and Certifications Demonstrated skills in effectively delegating and meeting deadlines. Experience In Respectful Communication With Physicians And Other providers. 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 are desired. High level of proficiency in MS Word, Excel, Outlook, and Visio are minimum requirements. Proficiency in MS Access, MS Project, 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 Enthusiastic, team player, who is an eager learner and driven to excellence. Ability to lead and motivate teams and motivate superior performance and the professional development of subordinate staff. Listening skills and conflict resolution skills. Ability to hire excellent staff best suited to each job opening. Ability to creatively approach systems development and improvement, and function independently while managing multiple priorities. Ability to plan, implement, and report on quality management activities; prepare clear and concise reports; maintain proper documentation and confidentiality. Knowledge of healthcare Quality Improvement, including HEDIS technical specifications, HEDIS compliance audit process, and other NCQA standards; and healthcare safety net and how clinical practices function is desirable. Knowledge of improvement methodologies such as Lean Six Sigma and/or Model for Improvement and PDSA cycles is required. 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. 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. HIRING MANAGER: $216,303.00 - $302,824.20 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.