Clinical Quality Program Manager

Working title: Clinical Quality Program Manager

Classification title: Medical and Health Services Managers (119111)

Department: CHC

Program: CHC Admin

Reports to: Senior Director of Clinical Operations Support

FLSA status: Exempt: FullTime

Wage Range: $6235 to $87896 annually; based on number of years of transferrable experience and internal equity

RiverStone Health:

Serving the Yellowstone County community and southcentral Montana for nearly 50 years RiverStone Health is an essential provider of personal and public health services. Health Education Leadership and Protection HELPis what we do. From medical dental and behavioral healthcare; home care and hospice; public health services like immunizations WIC health promotion and restaurant inspections; and educating the next generation of health professionals our expertise spans all ages and stages of life.

Program Overview:

The Clinical Quality Program Manager will lead and oversee the development implementation and ongoing evaluation of clinical quality initiatives across our Federally Qualified Health Center (FQHC) which is recognized as a PatientCentered Medical Home (PCMH). This position plays a critical role in advancing the organizations mission to provide highquality equitable and patientcentered care to underserved and diverse populations.

The Clinical Quality Program Manager will be responsible for designing and executing strategies to enhance clinical outcomes and population health to improve patient experience and ensure compliance with regulatory and accreditation standards including HRSA UDS PCMH and NCQA guidelines. This role involves close collaboration with medical nursing behavioral health dental and administrative leadership to foster a culture of continuous quality improvement (CQI) evidencebased practice and datadriven decisionmaking.

Job Summary:

Key responsibilities include leading quality improvement initiatives and projects managing clinical performance metrics ensuring timely and accurate reporting for internal and external stakeholders and guiding the organization in achieving excellence in care coordination chronic disease management and population health outcomes.

The Program Manager will champion universal care delivery leveraging health information technology informatics and data analytics to reduce disparities and enhance outcomes across the full spectrum of services provided by the health center. This leader will also oversee quality improvement staff and play a key role in provider engagement education and performance feedback.

Essential Functions/Major Duties and Responsibilities:

A. Program Management 50%

• Oversight of all clinical quality including monitoring validating improving and reporting.

• Ensure computerized record management systems are adequate communicate IT issues and recommend improvements.

• Ensure confidential information is safe guarded.

• Plan implement and administer projects and other quality improvement initiatives.

• Maintain awareness of advances in equipment IT software data processing government regulations and financing options.

• Monitor the use of equipment inventory facilities and other program resources that affect services provided including those internal and external to RiverStone Health.

• Manage change in integrated health care delivery systems such as work restructuring technological innovations and shifts in the focus of care.

• Maintain communication between staff leadership and other stakeholders by attending meeting and coordinating interdepartmental functions maximizing effectiveness and efficiency of interdepartmental operations.

• Establish objectives and evaluative operational criteria.

• Develop implement and ensure adherence to policies and procedures.

• Review and analyze facility activities and data to aid planning risk management and to improve service utilization.

• Prepare activity reports to inform management of the status and implementation plans of programs services and quality initiatives.

• Manage and lead complex programs and services utilizing effective communication knowledge resources and business processes maximizing customer service.

• Consult with medical business and other local community groups to discuss service problems respond to community needs enhance public relations coordinate activities and plans and promote RiverStone Health programs.

• Develop Quality improvement instructional materials and conduct inservice and communitybased educational programs.

• Coordinate the operational implementation of EHR and Information System changes as they relate to clinical processes.

B. Programspecific duties 45%

• Ensure compliance with all relevant grant requirements including but not limited to the Health Resources and Services Administration (HRSA) Operational Site Visit Protocol FTCA requirements and NCQA Requirements as related to quality improvement.
• Attend meetings conferences workshops and training sessions to become and remain current on developments in areas surrounding quality improvement project management and community health centers.
• Oversees the management and effective implementation of Value Based Care and insurance Payor Contracts.
• Lead and facilitate the Project Management process in the health center to ensure adherence to established priorities and appropriate resourcing for successful project implementation. Including multiple concurrent projects with teams of 3 20 members.
• Support and encourage innovation from all levels of staff while balancing available resources.
• Lead when appropriate and activity participate in RSH projects and committees.
• Ensure adherence to a robust Quality Improvement Program and culture including implementation of a boardapproved Quality Improvement Plan and associated procedures guidelines and education. Actively engage in personal and professional development in Quality Improvement Project Management Informatics and other relevant topics actively identifying and completing selfeducation as well as recommending and facilitating education for CHC leadership and staff.
• Research implement and manage population health activities that lead to improved patient care experience and safety.
• Collaborate and share quality improvement practices throughout the state with other health centers.
• Ensure that efforts for improvement include a focus on health equity and that potential disparities in care are addressed.
• Champion the adoption of new technologies and practices that support the CHCs commitment to highquality care.

NonEssential Functions/Other duties as assigned 5%

• Perform other duties as assigned in support of RiverStone Healths mission and goals.

Education and Experience:

Minimum Qualifications

• Three years of related Health care experience in a quality improvement role including leading teams.

• Project management experience.

• Proficiency in data analysis informatics and electronic health systems (EHR).

• High School Diploma or equivalent

• Any combination of experience and training which provide the equivalent scope of knowledge skills and abilities necessary to perform the work.

Preferred Qualifications:

• Bachelors degree in a related field

• Experience in health care operations and federally qualified health center preferred.

• Experience working with underserved population

• Medical Terminology

Required Certificates Licenses Registrations:

• Valid Montana State Drivers License

• Lean/Six Sigma Yellow Belt (must achieve within 1 year of hire)

Knowledge Skills and Abilities:

• Computer literacy in Microsoft Office Suite.
• Ability to maintain a calm and positive demeanor during difficult interactions.
• Ability to display nonjudgmental and empathetic listening skills.
• High degree of detailoriented skill level.
• Knowledge and understanding of protected sensitive patient health information (HIPAA) and confidentiality.
• Educate staff and show through example the significance and meaning of working collaboratively to maintain a positive work environment.
• Ability to perform job duties with integrity and innovation to ensure completion and a high level of quality.
• Ability to understand and adhere to required administrative policies and procedures.
• Excellent communication skills to ensure efficiencies and quality customer service.

Customer Service Excellence:

• Doing things right the first time

• Making people feel welcome

• Showing respect for each customer

• Anticipating customer needs and concerns

• Keeping customers informed

• Helping and going the extra mile

• Responding quickly

• Protecting privacy and confidentiality

• Demonstrating proper telephone etiquette

• Taking responsibility for handling complaints

• Being professional

• Taking ownership of your attitude toward Service Excellence.

Supervision:

No direct supervision

Physical Demands and Working Conditions:

• Occasional day travel to satellite clinics required

• May be expected to drive a vehicle which requires sitting seeing and reading signs traffic signals other vehicles etc. Travel occurs in all weather conditions including extreme heat and cold.

• Work is mainly done on a computer up to 8 hours a day.

• Create and maintain a safe/secure working environment by adhering to safety security and health requirements. Integrates injury illness and loss prevention into job activities by attending any necessary training and implementing best practices.

Freedom to Act & Decision Making:

• Decisions directly affect the quality of services provided to the public.

• Considerable leeway is granted for the exercise of independent judgment and initiative.

Communications & Networking:

• Presents to large and small groups regularly.
• Frequent written and verbal communication with RiverStone staff for the purpose of training and information delivery
• Works directly with leadership and department staff to develop quality training sessions
• Interaction with professionals across the state for program credentialing and management.

Budget & Resource Management:

Oversight of project and/or associated grant budgets as applicable ($20k $1million)

Required Experience:

Manager