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Director: Clinical Quality/STARS

2 months ago


Canonsburg, United States Preferred Primary Care Physicians, Inc. Full time
Job DescriptionJob Description

Preferred Primary Care Physicians (PPCP) is seeking a visionary and strategic leader to join us as the Director, Clinical Quality/STARS. In this critical role, you will drive the development and implementation of various quality care initiatives, with particular emphasis on organizational performance in Medicare STARS and commercial quality measures (gaps in care).

Why Join PPCP?

  • Impact: Make a significant difference in the healthcare industry by improving patient outcomes and reducing costs.
  • Innovation: Be at the cutting edge of healthcare transformation with a company that values creativity and forward-thinking solutions.
  • Growth: Enjoy opportunities for professional growth and development in a supportive and dynamic environment.
  • Benefits: Competitive salary, comprehensive benefits package, and a positive work-life balance.

Director, Clinical Quality/STARS Primary Purpose:

The Director, Clinical Quality/STARS drives the development and implementation of various quality care initiatives, with particular emphasis on organizational performance in Medicare STARS and commercial quality measures (gaps in care).

Director, Clinical Quality/STARS Essential Responsibilities:

  • Several key responsibilities include overseeing STARS/Quality support staff and defining data-driven strategies to maximize performance on value-based reimbursement across all contracted payor systems.
  • Lead or facilitate internal quality initiatives and participate in development of processes to improve quality outcomes.
  • Maximize impact and opportunities of pay for value programs, including focused efforts on CMS STARs to achieve successful results.
  • Provide ongoing communication on progress, opportunities for improvement and direction on areas of focus throughout the year to administration, physician leadership, stakeholders and forums.
  • Develop agenda, organize, and host monthly Quality Improvement meeting (in-person and virtual) including the procurement of clinical guest speakers.
  • Provide and ensure consistent education to providers and staff in areas of performance improvement related to quality and STAR metrics.
  • Review, analyze and update all areas of the Quality staff workflow, including but not limited to: Staffing levels; Recruitment for openings; Employee performance; Completion of audits; Management of staff based on departmental and organizational goals; Workflow productivity and efficiencies; Enforce policies and procedures; Manage PTO requests and staff coverage needs.
  • Ensure capture and management of all quality related data; ensure timely reporting and transmission of information by managed staff; and provide useful quality analytics to inform decision making.
  • Actively supports, institutes and implements within the organization any quality program initiatives and processes as outlined by the Quality Committee.
  • Collaborates with quality staff, office staff and providers to improve patient adherence to evidence-based guidelines, implement programs aligned with guidelines, and develop strategies to overcome barriers limiting success in achieving best practice parameters

Minimum Qualifications:

  • 5-7 years experience in practice operations, continuous quality improvement methodology and workflow redesign
  • 1-3 years experience with CMS and commercial pay for value programs

Preferred Qualifications:

  • Master's degree in Nursing, Administration, or a related field preferred
  • 5-7 years clinical experience in nursing, pharmacy, PT/OT, or related field
  • 3-5 years experience in a organization with proven successfully driven results

About Us:

At Preferred Primary Care Physicians, preferred health care is simply our standard. Our practice was established in 1995 when a group of dedicated physicians in the South Hills came together for one common purpose: to provide the highest quality care to their patients. Their ingenuity and expertise laid the foundation for our independently owned practice, which now operates out of more than 20 locations in the greater Pittsburgh area. Our elevated level of service is supported by our team-based approach, comprehensive clinical programs, and state-of-the-art outpatient centers. From providing general primary care to managing chronic conditions, we give all of our patients the preferential treatment they deserve.

Come join the team and enjoy a very competitive employee benefit package including medical, dental, vision, company paid life insurance, and 401k with competitive match.

Please visit our website www.ppcp.org for more info about our company.

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