Director of Quality Improvement

Company: Kernfamilyhealthcare
Location: Bakersfield
Posted on: September 22, 2023

Job Description:

Kern Family Health Care, 2900 Buck Owens Blvd., Bakersfield, California, United States of America Req #2015 Monday, May 8, 2023 We appreciate your interest in our organization and assure you that weare sincerely interested in your qualifications. A clear understandingof your background and work history will help us potentially place youin a position that meets your objectives and those of the organization.Qualified applicants are considered for positions without regard torace, color, religion, sex (including pregnancy, childbirth andbreastfeeding, or any related medical conditions), national origin,ancestry, age, marital or veteran status, sexual orientation, genderidentity, genetic information, gender expression, military status, orthe presence of a non-job related medical condition or disability(mental or physical). KHS reasonably expects to pay starting compensation for the position ofDirector of Quality Improvementin the range of $153,597- $199,676 annually.
Our Mission.. Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.

Definition
Under thedirectionoftheKHSChief MedicalOfficer andtheAdministrativeDirectorof Health Services, the Director of Quality Improvement will oversee and participate in activities related to quality improvement for the organization and membership by monitoring, assessing and improving performance in ambulatory and inpatient health care delivery or health care related services. The Director will implement the KHS Quality Management Plan and communicatewithcontractprovidersregardingrequiredstudiesandparticipation.Relatedduties will include ongoing data collection, medical record reviews, report writing, and collaboration and coordination with other KHS departments, as well as outside agencies.
DistinguishingCharacteristics

Thispositionisresponsiblefor qualityimprovement, HEDISreporting, healtheducation and disease management functions for KHS.Thisprofessional will beresponsible for ensuring compliance with the QI work plan, oversight of the design, implementation, analysis and dissemination of utilization and accessibility studies and member and provider satisfaction studies.TheDirectorofQIwillalsoberesponsibleforoverseeingtheproduction,analysis,and dissemination of contractually mandated reports.The Director of QI is also responsible for maintainingcompliancewithMedi-CalcontractualstipulationsforQualityprograms. Makesan effective contribution to KHS's business planning and fiscal processes.Is clear about departmental objectives and resource requirements.
KeepsKHS'squality plan "front andcenter",reinforcing a shared sense of purpose throughout theorganization.Takesamentoringroleandstronglyencouragesthegrowthofteammembers. Ensures that professional development goals are incorporated into team members' annual performance objectives, and regular reviews progress towards attaining them.
EssentialFunctions

- DesignsandimplementsQualityImprovementprogramsthatmeetthegoalsoftheKHS QI plan and complies with regulatory, contractual, and NCQA requirements. - MaintainsresponsibilityforallactivitiesoftheQualityImprovementstaffincluding policies, procedures, and operations. - WorksincoordinationwiththeProvider RelationsManager of SpecialProgramsto develop grant programs; - Providesleadership and supportto QIstaffinvolved in QIprojects. - AnnuallyupdatesQIpoliciesandprocedureswithinputfromtheQualityImprovementCommittee. - Participatesasanactivememberofplancommitteesrequiringpreparation,research,and follow-up as requested by the Chief Medical Officer. - OverseescredentialingprocessesandallHEDISrelatedactivities. - Supervisesqualityofcareinvestigationsandreporting. - Assistswithinterviews,selects,trains,developsandevaluatessubordinatestaff;provides input to Human Resources regarding disciplinary issues, as required. - Preparestheorganizationforreviewandtheaccreditationprocessesbymonitoringof external contract providers and internal processes. - ContributestotheoveralldesignofthePayforPerformanceIncentiveProgramin collaboration with Provider Relations department. - Coordinatesand conductsin-depth chartanalysis,datacollection,andreportpreparation. - Summarizesinformationcollectedforidentificationofpatterns,trends,andindividual cases requiring intensive review. - Identifiesandrecommendstheinitiationof qualityimprovementstudiesrelatedtomulti- disciplinary quality issues and State required studies. - Designsandmaintainsmonitoring systemsforthecollection ofHEDISdata. - Serves as staff support and resource to the Quality Improvement and Utilization ManagementCommittee,thePhysicianAdvisoryCommitteeandothercommittees,asappropriate. - Assistsinproblemidentification,dataanalysis,conclusions,recommendation,action- plan design, follow-up and tracking. - ImplementsandfacilitateinternalQualityImprovementstudiesandworkgroupsfor continuous improvement within the organization. - Performsotherjobrelated dutiesasrequired. - Adherestoallcompanypoliciesandproceduresrelativetoemploymentandjobresponsibilities.
EmploymentStandards

Education:Possession of a valid California R.N. license required; completion of a Master's DegreeinNursing(MSN) orhealthcarefieldfromanaccreditedcollegeor Universityorother relevant health care field REQUIRED. Certified Professional in Healthcare Quality (CPHQ) preferred or in lieu of related experience in quality improvement
Experience:Experience in QualityImprovementprogram implementation,research design, data collection, medicalrecordabstraction,andquantitativeanalysisof healthdatarequired.Previous experience in NCQA accreditation process REQUIRED Minimum of three (3) years staff and program management experience.
Knowledge of:Minimum of (5) five years managed care systems in a health maintenance organization(HMO).Applicablestandardsandregulationpertainingtoqualityimprovement programs for the Department of Health Services, NCQA, and HEDIS data collection and analysis; study design methods; appropriate quality tools and applications.
Ability to:Plan, coordinate, implement, analyze data and report on quality improvement activities;prepareclearconcisereports;maintainproperdocumentationandconfidentiality; communicate effectively with contracting providers and agencies; educate and motivate individuals; delegate and supervise employees.
Other:Possessionofvaliddriver'slicenseand proofofStaterequiredautoliabilityinsurance.RequiredTravel Upto20% We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.

• Kern Family Health Care, 2900 Buck Owens Blvd., Bakersfield, California, United States of America
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Keywords: Kernfamilyhealthcare, Bakersfield , Director of Quality Improvement, Executive , Bakersfield, California