Summary:
The Clinical Quality Coordinator is responsible for oversight of day-to-day activities of the quality department. The Clinical Quality Coordinator is responsible for assisting the Director of Clinical Quality in coordinating quality improvement initiatives, population health activities, care gap closure efforts, quality reporting, patient outreach, care coordination, and value-based care performance across the organization. The Clinical Quality Coordinator must be a strong advocate and champion for the elements of the Patient Centered Medical Home. The Clinical Quality Coordinator must support the Director of Clinical Quality in quality performance activities to ensure quality patient care.
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Essential Duties and Responsibilities:
General Management - Reporting to the Director of Clinical Quality, the Clinical Quality Coordinator manages the quality team. This includes RN Quality Case Managers & RN Wellness Nurses. The Clinical Quality Coordinator helps coordinate quality improvement activities and collaboratives to improve clinical quality/performance.
- Analyzes quality gaps within the organization, evaluates solutions, and utilizes best practice guidelines to guide quality improvement activities.
- Supports hiring, evaluates, trains, and supervises the quality coordinator, case managers, and wellness RNs.
- Supports a team approach to quality solutions within the organization.
- Externally, participates in quality collaboratives that support improvements in overall patient outcomes.
- Works collaboratively with the Manager of Clinical Support and the Non-Clinical Support Manager to support quality patient care.
- Maintains communication with all quality team members as well as other department leaders/directors to ensure understanding of quality initiatives, UDS, and PCMH requirements.
- Assists the Director of Clinical Quality in using nationally recognized population health methodologies to assist with development of annual quality plan.
- Assists in collecting and coordinating data for PCMH submission.
- Collaborates with the Director of Clinical Quality, Director of Payer Relations, & Care Gap Specialist on payer-related quality measures to include HEDIS, ACO, CIN, and any other activities and reporting.
Financial Management- Works closely with the Director of Clinical Quality in forecasting and preparing the annual budget.
- Help evaluate financial decisions that affect quality initiatives and incentives within the organization.
- Ability to understand the elements of the Performance Management Incentive Bonus Plan as it relates to scorecard calculations, NACHC percentages, and program requirements.
Human Resources
- Resolves department problems and openly communicates with quality staff to ensure high productivity and morale. Ensures that Leader Rounding activities occur regularly to ensure leader visibility and improve staff relations.
- Manages a quality team that includes care coordination and case management.
- Manages Performance Evaluation and staff relations for the Quality Team.
- Works closely with Human Resources in maintaining Employee Health issues, including but not limited to immunizations and vaccinations.
Compliance & Performance Improvement- Participates in maintaining organizational compliance with governmental regulations and industry requirements. Supports activities to maintain such compliance.
- Coordinates and assists in quality improvement performance programs.
- Supports and participates in organizational risk management and corporate compliance programs.
- Assists with UDS tracking of quality metrics and performance improvement activities.
- Supports team-based preparation for HRSA OSV reviews, review preparation, coordinating and follow-up.
- Maintains an understanding of Federal, State, and local laws and regulations that impact Grace Health’s ability to provide patient care.
- Performs other related duties as assigned by the Director of Clinical Quality and the Chief Medical Officer.
- Communication: Conveys information accurately and efficiently. Written communication is direct, concise, and easy to understand.
- Decision-making: Gathers necessary information to make good and timely decisions. Uses sound judgment and instincts. Seeks direction from Leadership appropriately.
- Supporting/Assisting: Seeks opportunities to help others be successful in meeting goals. Demonstrates behaviors reflective of our mission when helping others.
- Planning/Priority setting: Organizes tasks and objectives in order of importance, timing, and predicted results. Works within measurable goals and outcomes.
- Problem solving: Works systematically to solve problems. Develops reasonable and timely resolutions.
- Initiative: Takes prompt action to accomplish objectives. Seeks to resolve problems without being asked. Seeks direction from Leadership appropriately.
Key Functions:
- Knowledgeable of clinical quality measures and preventive health maintenance recommendations. Educates patients, family members, and other staff members in these areas as needed.
- Understands and adheres to regulations for FQHCs and Primary Care Centers. Maintains a comprehensive working knowledge of community resources, payer requirements, and network services for target populations.
- Understands population health and works collaboratively with the health care team to promote health and wellness.
- Develops strong knowledge of our electronic medical record and reporting capabilities.
- Works intimately with IT staff and Patient Care Teams to improve quality outcomes.
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Other Essential Duties and Responsibilities:
- Grace Health recognizes that managing patient care is a team effort that involves clinical and non-clinical staff. All employees must embrace a team-based approach to patient care and understand that each role is important to our success.
- Team members must demonstrate excellent team communication and coordination to provide quality patient care.
- Care coordination includes communicating with community organizations, health plans, facilities, and specialists.
- Care team members understand and embrace the concept of population management and proactively address the needs of patients and families served by this practice.
- Team members must demonstrate skill and knowledge related to effective communication with vulnerable patient populations.
- Team members must participate in Continuous Quality Improvement activities within the organization to ensure patients receive high quality care.
- All team members will be involved in the process of improving quality incomes.
- Team members will participate in the review and evaluation processes of practice performance and help to identify opportunities for improvement.
- Team members will participate in Grace Health's advocacy program.
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General Duties:
- Follows policies and procedures of the clinic and evidence-based guidelines for patient care.
- Maintains good attendance and adheres to staff requirements outlined in the Employee Handbook.
- Maintains timely documentation of all work assignments.
- Maintains patient confidentiality.
- Routinely keeps supervisor informed.
- Flexible in being able to multitask.
- Works effectively and at an efficient pace.
- Work cooperatively with providers, leadership, and other staff.
- Other duties as assigned by Director.
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Qualification Requirements:
To perform this job successfully, an individual must lead the advancement of Grace Health’s mission and perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Skills:- Communication
- Computer/Technology
- Conflict resolution
- Customer service
- Team building
- Time management
- Critical thinking
- Leadership
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EDUCATION and/or EXPERIENCE:
- Degree in Nursing. Bachelor’s degree preferred. Current license if applicable.
- Quality Management/performance improvement experience preferred.
- Community Health Center experience preferred.
- PCMH experience preferred.
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PHYSICAL DEMANDS:
The physical demands described here are representative of those that an employee must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk and/or hear. The employee frequently is required to stand, walk, sit, and use hands to finger, handle, or feel objects, tools, or controls. The employee is occasionally required to reach with hands and arms; stoop, kneel, crouch, or crawl; and taste or smell.
The employee must occasionally lift and /or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
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Work Environment:
Grace Health is a faith-based, federally qualified health center (FQHC). We provide primary healthcare services to underserved, underinsured, and uninsured individuals throughout southeastern Kentucky. Our mission is "to show the love and share the truth of Jesus Christ to southeastern Kentucky through access to compassionate, high-quality primary healthcare for the whole person."
The work environment characteristics described herein are representative of those that employees encounter while performing the essential functions of this position. Reasonable accommodation may be provided to enable qualified individuals with disabilities to perform the essential functions of the position.
The noise level in the work environment is typically moderate.
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