Director of Clinical and Quality Services - Full-Time - Provo

at  Revere Health

At Revere Health, we believe there is a better path to healing and healthcare maintenance, and we’re working on this mission—one patient at a time. We’re a national leader in a movement called value-base care which aims to improve treatment outcomes and keep costs down. Our internal culture is one that promotes respect and consistently recognizes the impact that individual employees have on the mission of the organization.

JOB SUMMARY

Provides strategic leadership in the planning, development, implementation, and execution of all aspects of Revere Health’s value-based programs and strategies. Emphasis will be centered around risk-based contract performance, risk adjustment, and quality measurement performance. Optimization of clinical quality and revenue opportunities for Revere Health’s VBC programs is a priority. Strategic integration with Revere Health’s Population Health team to support value-based performance and patient outcomes. Additional responsibilities include overseeing all aspects of clinical practices and policies to ensure regulatory compliance. Advises medical staff, department heads, and administrators in matters related to clinically based services. Oversight of quality metrics, clinical guidance, participation on the OSHA and Safety committee. The Director, under the direction of the Chief Medical Officer of Population Health serves as the programmatic and operational leader for Value-Based Care across Revere Health. The Director is responsible to the Chief Medical Officer of Population Health and works closely with Revere Health employees and leaders.

QUALIFICATIONS

• Bachelor’s degree
• At least 5 years of health care experience working with value-based Medicare Advantage STARS/HEDIS programs.
• At least 3 years of health care experience working with Medicare and/or Commercial risk adjustment programs. Requires working knowledge of CMS risk adjustment methodologies and quality improvement measures.
• Knowledge of regulatory quality-based reporting and audit requirements.
• Proficiency in interpreting results and formulating recommendations/action plans.
• Demonstrated skills in critical thinking, problem-solving, analysis, and evaluation of complex information.
• Excellent computer, organizational, project management and communications skills

Please refer the Job description for details