Manager of Provider Quality

4 weeks ago

Janesville, United States Mercy Health System Full time

Overview:

The System Manager of Provider Quality plans, organizes and leads quality assessment and improvement activities that directly impact peer review and medication staff quality. This is a system role. This position manages quality assessment and improvement activities for the medical staff of Mercyhealth. This system leader supports accomplishment of health system quality goals and implementation of quality improvement in operations, serving as an internal expert in data management and physician peer review. The Manager coordinates data collection efforts and utilizes multiple data bases to make needed information available to internal customers for use in re-credentialing and performance improvement efforts. Provides education to new physicians and physician leaders about the Peer Review process. Provides consultation to medical staff related to Peer Review; attends medical staff department and committee meetings as the liaison for Quality and peer review functions. Serves as an internal expert for leaders with regards to data management and peer review processes.Manages identified partners. Participates in Occurrence Reporting for the hospital. Responsible for other duties as assigned.

Responsibilities:

Essential Duties and Responsibilities

  • Manages peer review and data reporting functions of the medical staff, using clinical triggers and occurrence reporting for case finding
  • Educates and coaches new physicians and physician leaders about the Peer Review process and quality measures.
  • Works with members of the medical staff and system leaders to ensure timely reviews and provides information as needed
  • Attends medical staff department meetings as the Quality and Peer Review representative; provides reports and feedback as requested.
  • Manages physician reporting activities and coordinates work to ensure standardization across the organization
  • Analyzes performance, identifies trends and makes recommendations to the Medical Staff for new measures.
  • Educates Leaders and Medical Staff on new measures, requirements and impact on the organization
  • Provides oversight of reports and data used for physician performance improvement, ongoing professional practice evaluation and focused practice evaluation
  • Collaborates with medical staff leadership, risk management and administrative leaders to makes recommendations for further investigation or improvement
  • Participates in committees related to performance initiatives of the Medical Staff
  • Ensures coordination of measures and indicators and standardization of process between facilities
  • Collaborates with multiple departments to ensure data validity, reliability, accuracy and timeliness.
  • Assists with accreditation preparation and compliance monitoring related to quality, performance improvement and medical staff standards.
  • Participates in planning and project management as requested.
  • Provides direct managerial oversight to identified partners, including Data Specialist staff. Leads annual evaluation and quarterly coaching meetings.
  • Assists in the preparation of and adherence to the department budget.


Culture of Excellence Behavior Expectations

To perform the job successfully, an individual should demonstrate the following behavior expectations:

Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.

Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.

Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.

Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.


Education and Experience

  • Bachelors degree in nursing preferred

OR

  • Healthcare related bachelor's degree with 5 years of experience in a healthcare field required
  • Completion of a medical terminology class preferred.

Previous managerial or supervisory experience with progressively increasing responsibility required.
Quality background required including previous experience with data measurement, report analysis and data interpretation is preferred.
Advanced level of experience using Microsoft Excel is required. This includes the ability to create and maintain spreadsheets, manage the graphical display of data, utilize advanced functions and formulas.
Moderate level of Microsoft Access experience is preferred. This includes database creation, table maintenance and related problem-solving.


Certification and Licensure

CPHQ certification within 2 years required


Skills and Abilities
Excellent interpersonal and communication skills.
Ability to define problems, interpret data, establish facts and draw valid conclusions.
Ability to work with partners in achievement of strategic goals.
Position requires a high level of independent judgment and has latitude for independent action.

Special Physical Demands

The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.
While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel. Employee is required talk and hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand; walk; sit and climb or balance. The employee must regularly lift and /or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and distance vision.


Level of Supervision

Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems; employee adherence to annual education and certification requirements


Supervises

Directly supervises Data Specialist 1, 2 and 3. Supervisory responsibilities are conducted in accordance with directives of management, the organization's policies, and applicable laws.

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