Clinical Quality Advisor

1 week ago

NC United States Unified Women's Healthcare Full time

Overview:
*Candidates must be located in North Carolina*Unified Women's Healthcare is dedicated to supporting Ob-Gyn providers and their teams. Our organization is comprised of professionals with extensive experience in both business and healthcare, all united by a common goal - exceptional care requires exceptional support. We pride ourselves on not just discussing this commitment but actively implementing it.


Our mission is to serve as a vital resource for business acumen, innovation, and assistance to the practices within our network.

We advocate for our Ob-Gyn medical affiliates, allowing them to concentrate on delivering medical care while we manage the business aspects of healthcare.

We are proactive in our approach. We strategize, implement, and execute initiatives on behalf of the practices we support.


The Clinical Performance Partner (CPP) plays a crucial role in assisting care centers with the execution of prioritized clinical initiatives, quality enhancement, ancillary utilization, and performance metrics related to value-based care models.

The CPP will engage with care centers both in-person and virtually to educate and eliminate obstacles in achieving affiliate objectives concerning quality and merit-based incentive programs.

Additionally, the CPP will facilitate the affiliate's Quality/Value Committee to ensure that quality metrics are clearly defined and monitored, addressing any variances proactively.

Support will also be provided for the utilization of physician-owned laboratory services, breast imaging, and in-office procedures through education, data analysis, influencing provider practices, and identifying and resolving workflow or EMR usage gaps.

The CPP will collaborate closely with the Medical Director and/or Value-Based Care lead physician to enhance care quality, patient experience, and maximize incentive payments and savings.


Responsibilities:
Deliver ongoing strategic guidance, training, and coaching to provider groups on program implementation and overcoming barriers.

Educate care centers on new or modified value-based care agreements with various payers; develop and provide educational materials to optimize their performance.

Train care center staff on the effective and efficient use of laboratory services through data analysis, proactive communication, and performance improvement strategies.

Enhance laboratory utilization by reviewing workflows and troubleshooting to minimize turnaround times caused by collection errors and reduce opt-out rates.

Encourage increased use of on-site breast imaging services and collaborate with the Unified Mammography team to identify new installation opportunities.

Promote the use of in-office procedures where capabilities exist and assist care centers with protocols, space planning, equipment procurement, anesthesia coverage, etc., to initiate services.
Collaborate with cross-functional partners, such as Revenue Cycle Management, Contracting, and payers, to reconcile value-based care payments.
Develop policies, workflows, scorecards, etc., to support standardization and error-proofing.
Facilitate the Quality / VBC Committee
Participate in Lab Committee and other relevant Laboratory Leadership meetings
Provide reports to Affiliate and Unified leadership on overall performance progress and gap closure.
Lead regular meetings with care centers as required, including preparation of reports and materials.
Analyze care center workflows, offer suggestions, and monitor execution.

Engage in special projects aimed at developing new clinical offerings within the market, such as laborist programs, urgent care, triage phone services, and new sub-specialties.


Qualifications:
Nursing Degree preferred, Bachelor's Degree required.
5+ years of experience in the healthcare industry.
5+ years of experience working for a health plan and/or a provider's office.
Proven experience in leading initiatives/projects.
Ability to travel 40%
Must be located within driving distance of the Care Centers in North Carolina

#unifiedwhc

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