Director of Quality and Population Health Management

2 days ago

Gastonia, North Carolina, United States Kintegra Health Full time
Job Title: Director of Quality and Population Health

Job Summary:

Kintegra Health is seeking a highly skilled and experienced Director of Quality and Population Health to lead our quality management work plan and program description. The successful candidate will provide overall leadership and direction for the quality of care and population health for our patients, improving outcomes and advancing continuity of care.

Key Responsibilities:

  • Develop and implement a standardized quality management work plan and program description to ensure compliance with external regulatory requirements.
  • Develop the annual Quality Program Evaluation and update the QI Program Description and Workplan in coordination with the Chief Quality Officer.
  • Research and document current healthcare standards for use in performance improvement study design and methodologies related to health outcomes.
  • Serve as the liaison for Medicaid Health Plans, Clinically Integrated Networks, Payers, Providers, and other state agencies in the provision of case management services.
  • Manage case management programs, including Medicaid Managed Care, Medicare Shared Savings Program, Commercial, and Uninsured Case Management programs.
  • Understand the service delivery system for healthcare programs administered by the state and federal government and be an expert in regulations and requirements.
  • Facilitate and attend meetings with the state, health plans, community agencies, and other key stakeholders.
  • Build and implement comprehensive plans to capture, analyze, and utilize data on outcomes of clinical interventions and costs.
  • Design, develop, implement, and sustain improvement of health outcomes, outreach, and education programs.
  • Participate in the development of the budget, goals, and objectives of the department and provide consistent communication to leadership ensuring progress toward agreed-upon objectives.
  • Develop and motivate department employees to effectively deliver upon objectives in an efficient and innovative manner.

Requirements:

  • 5+ years' experience with quality, population health, and case management and 10+ years' experience in Nursing.
  • Experience in managing multiple, large-scale, complex projects.
  • Ability to effectively manage provider relations.
  • Strong and effective oral and written communication skills.
  • Ability to work extended hours and weekends when needed.

Kintegra Health Core Requirements:

  • Patient First – An approach to care that holds primary the well-being and desires of the patient.
  • Build not Blame – Focusing first on finding fault with the process rather than the person.
  • Integrity and Honesty – Fostering an acceptance of openness, honesty, and fairness in words, deeds, and the use of organizational resources judiciously for both internal and external customers.
  • Cooperation and Flexibility – Related to an internal believe that we function as part of an interdependent team with only shared gains or losses thereby committed to assisting whenever possible beyond the prerequisite job description.
  • Culturally Sensitive – Always working toward increasing one's ability to understand, communicate with, effectively interact, and care for people across cultures, while having an acute awareness of one's own culture.

We are an equal opportunity employer and value diversity.

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