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Company Greenville Health System
Location Greenville, SC
Update 4 Day ago
Job Class




Job Summary

Develop, guide and oversee CCI's strategy, program and product development, process engineering and related implementations and services that further CCI and its customers goals and objectives with regard to ambulatory care transformation and quality reporting. Oversee operations that further CCI's ambulatory care transformation and quality programs including use of the EMR to document and collect quality indicators, process engineering in support of care transformation, and related product and service offerings. Work collaboratively with CCI and provider information techology teams to validate and track quality data, and associated value-based reimbursements for CCI's clients including healthcare delivery systems, accountable care organizations (ACOs) and clinically integrated networks. Work collaboratively with CCI's and our clients providers and practices, clinical, policy, business intelligence, and technology teams to conceptualize, explore, and innovate in the areas of quality metric reporting and performance improvement. Lead CCI efforts to identify best practices in ambulatory care transformation, quality and performance improvement, and process engineering to develop programs that can be implemented across multiple clients. Lead the development and operations of the programs including the education and oversight and monitoring of the programs and reporting to third party organizations including government payors (CMS/Medicare, Medicaid, employers and commercial payors). Further CCI's goals for delivering innovative products and services to health care organizations in support of population health by continuously challenging how health care are delivered, managed and financed. Work closely with senior leadership and operational team leaders to analyze the opportunities and assess product, market and financial opportunities and risks. Be a leader in understanding the tranformation of health care delivery systems, particuarly with regard to quality reporting and performance improvement programs including efforts around primary care performance improvements by building a product portfolio that anticipates the future needs of clinically integrated delivery systems. Be the CCI expert on how quality reporting and performance improvement effects the overall performance of CCI clients and work to continuously improve those outcomes (clinical and reimbursement). Manages a team of quality specialists and other clincial and technical professionals.

Supervisory/Management Responsibilities

Job has direct and/or indirect supervision of employees that may include final budget authority, hire/termination/disciplinary authority, performance appraisal responsibility. Job will be considered a member of the management staff with direct reports..

Minimum Education

Master's Degree in Health Care Administration (MHA), Health Care Policy/Public Health (MPH), Nursing (MSN), Business (MBA), or Law (JD)

Minimum Experience

10 years of experience with at least 5 years of experience in the health care industry with preferred experience/emphasis on clinical quality programs

Required Certifications/Registrations/Licenses


Specific Acceptable Credentials (if applicable)

Not applicable

In lieu of the Above Minimum Requirements

Other professional degrees including Doctorate's degree in related field, or Medical Degree (MD) may be substituted for up to two (2) years of experience

Other Required Experience

Proven experience implementing quality improvement programs that resulted in a material improvement in health quality reporting scores. - Required
Experience working with federal (CMS) quality programs including CMS' Medicare Shared Savings Program (MSSP) and/or Medicare Advantage, CMS' Physician Quality Reporting System (PQRS) with a strong understanding of quality metrics including federal reporting. - Required
Experience that includes program design and implementation in the areas of quality improvement especially with regard to primary care transformation through programs such as Patient Center Medical Home (PCMH), Chronic Care Management (CCM), and/or Comprehensive Primary Care (CPC+) and/or related commerical insurance primary care and quality programs. - Required
Experience in process improvement (including lean six sigma methodologies), program development, and project management. - Preferred

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