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Tenet Healthcare Quality Manager - St. Vincent Med Group Admin in Worcester, Massachusetts

POSITION SUMMARY

Reporting to the Market Operations Manager, this position serves as coordinator, facilitator and resource to support the Quality Improvement initiatives. Promotes healthcare outcomes in accordance with the policies, procedures, mission and vision of Tenet Physician Resources. Provides training and education to the physicians and staff to promote evidence based medicine, regulatory agency compliance, and ensure quality care to minimize patient harm.

SIGNIFICANT RESPONSIBILITIES & ACCOUNTABILITIES

  1. Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Physician Resources.

  2. Adheres to the Tenet HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.

  3. Demonstrates support for the Tenet Physician Resources Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.

  4. Develops, coordinates and implements quality improvement programs.

  5. Develop policies and procedures that promote quality care and patient safety.

  6. Oversees systems for collection, monitoring and reporting of data collected for quality improvement measures, health plan and regulatory agency compliance.

  7. Conducts data analysis relating to quality improvement to ensure that care provided meets or exceeds standards.

  8. Educate physicians and extenders on standards of care as relates to their practice.

  9. In conjunction with the EMR team develop, implement and oversee clinical workflow as it relates to quality measures.

  10. Maintains a thorough working knowledge of continuous improvement processes relating to P4P, PQRI, HEDIS and other quality measures utilized by CMS, regulatory agencies and health plans

  11. Review physician records for quality issues, identify circumstance falling outside established parameters, and follow up appropriately.

  12. Investigates and communicates identified potential quality or risk issues.

  13. Facilitates root cause analysis and leads team in identification of system issue.

  14. Conforms to the established Standards of Behavior.

  15. Other duties as assigned

POSITION QUALIFICATIONS (including required licenses/certifications, education and job knowledge/experience):

  1. Completion of an accredited Nursing Program

  2. Current State RN nursing license. Current CPR certification.

  3. Minimum of three years’ experience in ambulatory healthcare setting

  4. Knowledge in continuous quality improvement theory, statistics and process improvement reporting

  5. Basic understanding of medical terminology.

  6. Knowledge of medical office procedures and process.

  7. Knowledge of clinical equipment, supplies, and instruments.

  8. Understanding of documentation required for physician office visits.

  9. Knowledge of the purposes, organization, and policies of the local community's health systems sufficient to interact with other health care providers.

  10. Knowledge of the policies and procedures of a clinic sufficient to provide effective patient care.

  11. Must have good understanding of industry standards around disease management such as NCQA.

  12. Strong medical knowledge and competence in chronic disease pathophysiology, polypharmacy, clinical assessment, and patient/family education.

  13. Demonstrated ability to problem solve and manage professional relationships.

CUSTOMER SERVICE RESPONSIBILITIES:

Performs duties while demonstrating strong, interpersonal and communication skills that allows work to flow in a positive, constructive, and professional manner. Works with all team members to facilitate congenial and professional working relationships with subordinates, peers, and superiors thus creating a harmonious work environment. Ensures that all contacts with patients, senior leadership, managers, the public, physicians and other personnel are carried out in a friendly, courteous, helpful and considerate manner. Answers telephones in a prompt and courteous manner. Displays concern and provides assistance or explains procedures as appropriate to callers or in face-to-face situations. Dedicated to meeting the expectations and requirements of internal and external customers. Works with customers to identify problem areas and recommend solutions.

PHYSICAL, MENTAL & ENVIRONMENTAL DEMANDS:

To comply with the Rehabilitation Act of 1973 the essential physical, mental and environmental requirements for this job are listed below. These are requirements normally expected to perform regular job duties. Incumbent must be able to successfully perform all of the functions of the job with or without reasonable accommodation.

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Job: Non-Clinical/Administrative

Organization: Staff St Vincent Phy Svs

Title: Quality Manager - St. Vincent Med Group Admin

Location: MA-Worcester

Requisition ID: 2005032723

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