Market Executive of Clinical Quality
2 weeks ago
Become a part of our caring community and help us put health first The Market Executive of Clinical Quality will be responsible for driving clinical quality and regulatory metrics by onsite leadership in assigned market. The Market Executive will be accountable for the following: clinical and survey metrics, clinical operations metrics, claims denials, AO/state survey results, risk mitigation, clinical compliance, QAPI adherence and VBP performance. Works closely with area operations and branch leaders on processes, initiatives and relevant in-scope changes or updates.Essential Functions:( Those functions that the individual who holds the position must be able to perform unaided or with the assistance of reasonable accommodation).Drives improvement in clinical quality & regulatory metrics in assigned branches through coaching frontline clinical managers and staff on improving care delivery and documentation requirements.Implements and monitors clinical performance of advanced clinical care programs into assigned branches. Regularly monitors quality metrics for assigned Market; Reports key insights to AVP of Ops & Area Exec of Clinical Quality and other key Clinical/Ops stakeholders.Conducts survey audits to prepare for official surveys and supports locations through survey process.Conducts meaningful virtual/in-person branch interactions to drive performance.Knowledge/Skills/Abilities/Expectations:Knowledge of business management and government regulations; expertise in relevant state regulations and survey activitiesAbility to read, analyze and interpret medical documents, financial reports and legal documents.Ability to coach/mentor branch leadership and clinicians to influence changes in day-to-day clinical activities.Proactively engages to identify and address issues.Expertise in branch-level clinical workflows an organization structureRich analysis of clinical data to derive key insights & opportunities.Strong judgement on workflow and process improvementEffective influencing and communicationStrong execution capabilities60- 90 branch in person touchpoints per yearTravel approximately 50% -75%.Use your skills to make an impact Qualifications:Education:Bachelor’s degreeLicenses/Certification:Clinical licensure in geography assigned: Nursing or TherapyExperience:Previous experience in branch leadership (Branch Director/Administrator or Clinical Manager) preferred.Knowledge of HCHB preferred.Scheduled Weekly Hours40Pay RangeThe compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $102,200 - $140,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.Equal Opportunity EmployerIt is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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