Job Details

Overview

The Senior Director of Quality and Performance Improvement is a key individual on PHC'sSenior Leadership Team and is responsible for leading a growing Quality Department atPartnership HealthPlan of California (PHC) through quality and performance improvementactivities 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 initiativesorganization-wide, including prioritization of efforts.
• Lead, develop, and coach the Quality and Performance Improvement staff including staffhiring, training, performance appraisals, goal setting, and resource allocation. Assessoverall performance using internal and external feedback mechanisms to activelyoptimize capacity within the department while leveraging individual strengths andnurturing career development plans.
• Manage the Quality and Performance Improvement budget.
• Oversee PHC's quality improvement program, ensuring all interventions are measuredfor effectiveness and efficiency, complete annual review and update of the program, andwrite annual plan.
• In collaboration with the CMO and CFO, oversee the administration of PHC's pay forperformance programs.
• Oversee performance improvement activities conducted by the quality department,including PHC's Partnership Improvement Academy, DCHS mandated improvementwork, performance improvement and engagement activities done with the PHC network.
• Oversee Quality department activities key to the success of inter-departmental qualityinitiatives and the achievement of organization-wide quality goals.
• Oversee PHC's provider level quality data visualization and analysis program, thePartnership Quality Dashboard.
• Oversee the monitoring and improvement activities surrounding PHC's “Internal QualityDashboard” also known as the PHC Stars, to evaluate and monitor the quality of careprovided to PHC members.
• Prepare the organization for quality and performance improvement review, survey, andaccreditation processes by external monitoring agencies, such as DHCS, DMHC, CMS,or NCQA.
• Oversee the optimization of monitoring systems for collection and reporting of HEDISdata, including the statewide improvement projects aimed at improving performance inHEDIS 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 improvementcommittees, physician committees, and PHC's Board of Commissioners as appropriate.
• Oversee the coordination of QI activities and data collection for PHC's contractedmedical groups and providers.
• Organize and prepare all materials and serve as staff resource for assigned PHCcommittees.
• Work with assigned committees to identify barriers and design intervention strategiesfor quality and performance improvement.
• Write, review, and seek approval for policies and procedures, ensuring that both thedepartmental 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 degreepreferred. Formal certification in areas of professional expertise such asLean Six Sigma, IHI's Improvement Advisor Program, and training inthe Model for Improvement is desirable. Minimum of five (5) yearsmanagement experience in a medium to large size organization.Experience should include managing multifaceted quality andperformance improvement projects. Working knowledge of principlesand techniques of effective management, including training andevaluation. In depth knowledge of Quality ImprovementMethodologies. Grant writing and grant management experience isdesirable.

Special Skills, Licenses and Certifications

Demonstrated skills in effectively delegating and meeting deadlines.Experience in respectful communication with physicians and otherproviders. Superior communication skills, adaptability, openness tofeedback and new ideas. Excellent project management skills,including project planning, resource allocation, and completion statustracking and reporting. Strong critical thinking and data analytic skillsare required. Advanced data analytic skills are desired. High level ofproficiency in MS Word, Excel, Outlook, and Visio are minimumrequirements. Proficiency in MS Access, MS Project, and reportingsoftware desirable. Valid California driver's license and proof ofcurrent automobile insurance compliant with PHC policy are requiredto operate a vehicle and travel for company business.

Performance Based Competencies

Enthusiastic, team player, who is an eager learner and driven toexcellence. Ability to lead and motivate teams and motivate superiorperformance and the professional development of subordinate staff.Listening skills and conflict resolution skills. Ability to hire excellentstaff best suited to each job opening. Ability to creatively approachsystems development and improvement, and function independentlywhile managing multiple priorities. Ability to plan, implement, andreport on quality management activities; prepare clear and concisereports; maintain proper documentation and confidentiality.Knowledge of healthcare Quality Improvement, including HEDIStechnical specifications, HEDIS compliance audit process, and otherNCQA standards; and healthcare safety net and how clinical practicesfunction is desirable. Knowledge of improvement methodologies suchas Lean Six Sigma and/or Model for Improvement and PDSA cycles isrequired.

Work Environment And Physical Demands

Must be able to work in a fast paced environment and maintaincourtesy and composure when dealing with internal and external

customers. Ability to function effectively with frequent interruptionsand 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.