20 days old

Vice President, Quality and Outcomes

Keystone Peer Review Organization, Inc.
Bloomington, MN 55431
  • Job Code
    VPQUA01958-00001

KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.KEPRO is seeking resumes for a highly experienced professional



Vice President of Quality and Outcomes



Summary Description


Responsible for corporate wide quality, quality improvement, and clinical outcomes reporting. Provides strategic oversight of corporate quality activities and reports directly to KEPROs President. Oversees system-wide quality and value-improvement activities including the collection of quality data. Works closely with IT team on analysis of data to drive quality outcomes reporting, analysis, and improvement. Tasked with overseeing corporate quality assurance and accreditation team. Promotes quality improvement and ensures adherence to quality standards and advises the President and CEO of opportunities to improve delivery of services and resolve identified problems. Provides the principal leadership and clinical expertise to the Corporate Quality Performance team regarding all medical quality aspects relating to KEPROs contracts including but not limited to the peer review process, utilization review activities, case/disease management, tracking and evaluating clinical data. In partnership with all divisions, develops and implements corporate-wide quality indicators to monitor each divisions effectiveness.


Accountabilities


  • Ability to aggregate, analyze, and report on quality intelligence data

  • Oversees the reporting and transparency of clinical data

  • Provides leadership over the Quality Assurance team and oversees contract quality audits to ensure compliance with policies and procedures including the standardization of clinical quality activities across the KEPRO enterprise.

  • Improve consumer outcomes by ensuring all clinical care is delivered in a manner that meets or exceeds client and KEPRO goals and expectations for clinical outcomes, quality performance standards, and consumer and client satisfaction.

  • Develops strategic plan, in conjunction with quality assurance team, to ensure successful corporate accreditation processes.

  • Analyzes and stays current and informed on all applicable federal and state regulations and compliance requirements.

  • Designs, Develops and implements policies and procedures for Performance Improvement Plans.

  • Develops strategies to ensure compliance with corporate policies, procedures and product and services guidelines.

  • Reviews and directs submission of monthly, quarterly and annual reports as required.

  • Measures and reviews aggregated outcomes from select initiatives and provides recommendations.

  • Educates and assists business units to maintain appropriate policies, procedures, and documentation to achieve desired clinical outcomes and fulfill requirements and regulations.

  • Represent and promote KEPRO at seminars, professional societies, and other external/internal professional settings as appropriate.

  • Ensures all state license/certification requirements are met.


Travel Requirements


  • Some travel across the Country is required.


Qualifications


  • M.D. or D.O. with current non-restricted license to practice medicine by the Board of Medical Examiners.

  • Board certification in a clinical specialty is required.


Knowledge, Skills, Abilities


  • Has strong knowledge of current healthcare concepts in Health Outcome Measurement and Performance Improvement,

  • Contemporary clinician who understands major trends in healthcare and managed care.

  • Ability to work effectively with a diversity of personalities. Must be approachable; show respect for others, and a consensus builder.

  • Systems thinker with strong organizational skills who can pull all the pieces together and deliver on time and within budget.

  • Adaptable with strong collaborative management style, a creative thinker with high energy and enthusiasm, and a team player who promotes the concepts of people working together.

  • Able to adapt to frequently changing work parameters.


Experience


  • 10+ years of clinical practice preferred.

  • 5 to 7 years of experience as a physician executive with significant accomplishments in developing managed care strategies, integrating delivery systems, improving quality and utilization management programs and coaching medical staff on healthcare business and practice issues.

  • Minimum 2 years as a Medical Director in a managed care company preferred.

  • Experience in Utilization Management, Case and Disease Management with knowledge of Medicaid and Medicare programs.

  • Prior review experience or quality performance committee responsibility in a hospital or managed care setting preferred.


Mental and Physical Requirements



The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.




KEPRO offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements.Only those candidates identified for an interview will be contacted.No Phone Calls Please.Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.



EOE AA M/F/Vet/Disability



KEPRO is an E-Verify employer. E-Verify is an internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information.



See job description





Posted: 2019-04-29 Expires: 2019-05-28
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Vice President, Quality and Outcomes

Keystone Peer Review Organization, Inc.
Bloomington, MN 55431

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