Austin Regional Clinic: ARC · 1 day ago
Clinical Quality Manager
Austin, TX
Full-time
Onsite
Mid, Senior Level
3+ years expAustin Regional Clinic is one of central Texas’ largest professional medical groups, recognized as a top employer for over 15 years. The Clinical Quality Manager is responsible for overseeing clinical quality strategy initiatives and managing relationships with payer partners to improve quality and cost outcomes.
Health CareMedical
Responsibilities
Oversees implementation of clinical and quality strategy of ARC’s value-based contracts including collaboration with ARC’s operational leads, payers and partners to achieve quality goals
Manages health plan clinical quality relationships and business operations
Serves as clinical liaison with payer partners and ensures deliverables are met. Develops presentations/reports and participates in discussions to facilitate effective JOCs with payers
Responsible for recruiting, coaching, motivating, scheduling, evaluating, and training employees
Responsible for performance evaluations, disciplinary actions, staff training and development, promoting teamwork and fostering a positive work environment
Assumes a leadership role in executing clinical projects including the implementation and management of new quality programs, quality measures, applications and new lines of business including new risk arrangements
Leads coordination of performing and submission of ACO, HEDIS and Medicare STARS clinical abstraction and quality attestation process for all value-based health plans
Attends Clinical Quality Committee, Pedi Clinical Quality Committee and Nursing Ops (if applicable) meetings regularly and participates on sub-committees as needed
Identifies, analyzes and prepares evidence-based and clinically actionable materials for Clinical Quality Committee review and distribution on matters involving patient and employee health
Researches clinical quality best practices, provides recommendations, and assists with implementation for all specialties with quality initiatives
Develops and implements Population Health/Clinical Quality-specific written policies, protocols and programs, and monitors adherence to system-wide policies/standardizations
Participates and directs continued development of ARC provider scorecards and integration into ARC practices
Oversees quality metric performance and ensure goals and objectives are met
Works with operational management and nursing leadership to develop cooperative processes to assure effective coordination on various quality improvement projects
Tracks and monitors quality performance and engages in open and constructive dialogue with teams
Defines methods for measuring program success and demonstrating program effectiveness in partnership with Clinical Analytics team
Leads ARC Clinical Quality Committee activities, meetings and discussions with and between departments within the organizations
Promotes long term financial stability and sustainable growth to safeguard our ability to continue to offer high quality, coordinated care
Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct
Regular and dependable attendance
Follows the core competencies set forth by the Company, which are available for review on CMSweb
Interviews prospective employees and communicates with Human Resources throughout the hiring process
Performs other duties as assigned
Qualification
Required
High school diploma or equivalent. Bachelor of Science degree
At least three (3) or more years of experience working in quality improvement, a managed care setting, or population health
Previous management or project management experience, including experience engaging and collaborating with all levels of staff, multiple management levels including clinical teams, business leaders, and physicians
Preferred
Master's degree in healthcare related field
Graduate of accredited nursing school
Knowledge and experience with ACOs and/or experience related to value-based payment structures
Knowledge of HEDIS and Medicare STARS measures, MSSP ACO requirements or other population health based programs
Experience with clinical quality program administration
Prior experience working with physicians and physician organizations
Prior experience working with performance and quality improvement processes and project management
Licensed Registered Nurse in State of Texas preferred
Current AHA approved Basic Life Support (BLS) Healthcare Provider Cardiopulmonary Resuscitation (CPR) course completion card preferred
Benefits
Medical
Dental
Vision
Flexible Spending Accounts
PTO
401(k)
EAP
Life Insurance
Long Term Disability
Tuition Reimbursement
Child Care Assistance
Health & Fitness
Sick Child Care Assistance
Development
Company
Austin Regional Clinic: ARC
Austin Regional Clinic (ARC) is a multispecialty medical group committed to providing comprehensive, coordinated healthcare services throughout Central Texas.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
M
Manish Naik
Chief Medical Officer and CMIO
Recent News
Austin American-Statesman
2024-12-29
Company data provided by crunchbase