medical insurance, dental insurance, life insurance, paid time off, paid holidays, sick time, extended sick time, tuition reimbursement, 403(b), retirement plan
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Description
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The primary purpose of this position is to develop, recommend and implement interventions at the practice and management levels to improve clinical quality and operational efficiency and to collaborate with FQHC practices to facilitate redesign efforts, support care teams, introduce population health management and support achievement toward improved financial, process and clinical outcomes. The scope of these functions includes care management, risk adjustment, quality practice transformation, value-based care and EHR maximization.
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Examples of Duties
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A. Administration 65% 1.Serves as a liaison to practices to provide on-site and remote assistance and facilitation to the clinicians, care teams and their associated practices to drive improvement in clinic quality and operational efficiency. 2.Supports and advises health Practice leadership, providers and staff on their transformation efforts toward value-based care. 3.Partner with Health Center and Practice leadership in preparing to transform and improve primary care for more advanced value-based payment contracts and models. 4. Supports ad oversees progress with practices in achieving total cost of care and quality performance goals 5.Understands risk stratification, quality improvement and population health and drives improvement on related engagement, outcomes and financial measures. 6.Reviews health center and practice performance on Key Performance Indicators (KPls) and informs leadership on insights, data trends and leasing or lagging performance. 7.Develops and executes set of intervention work plans to drive practice improvement quality measures and transformation. 8.Develops and implements workflow design and redesign, including electronic health record organization, clinical documentation, billing practices, assessments, financial analyses, and finance performance improvement reporting. 9.Develops and implements change to root causes of financial and quality underperformance and communicate strategies to clinic leadership and providers. 10.Revises and interprets summary data and performance reports such as pay-for-performance, HEDIS measures and medical cost ratios and develop data drive provider performance strategies. 11.Actively participates in cross-function teams to conduct work and resolve enterprise-wide and regional issues. 12.Serves as liaison with MCOs in developing practice incentives for the FQHC. 13.Coordinates PCMH designation and certifications for all FQHC clinic sites. 14.Directly supervises support staff in the Practice Transformation and Quality Unit. 15.Responsible for coordination and dissemination of emergency management procedures. 16.Assists with FQHC strategic planning and business development. 17.Adheres to internal controls as established by the university and the FQHC.
B. Risk Management 20% 1. Conduct regular risk assessments and audits to identify potential risks in clinical and administrative processes. 2. Monitor incident reports, patient complaints and safety trends to detect early warning signs of risk. 3. Develop, implement and maintain risk management policies, procedures and protocols. 4. Ensure policies are in compliance with regulatory, legal and accreditation requirements (e.g., HIPAA, Joint Commission, FTCA). 5. Coordinate root cause analyses and implement corrective action plans. 6. Provide ongoing training on risk management principles and procedures. 7. Promote a culture of safety and compliance within the department. 8. Participate in emergency preparedness planning and response initiatives.
C. Professional Activities 15% 1. Keeps abreast of changes in the Medicaid and Medicare coverage through FQHC professional organizations such as the Illinois Primary Health Care Association (IPHCA) and the National Association for Community Health Centers. 2. Keeps abreast of federal changes through the Health Resources and Services Administration (HRSA) and ECRI patient risk and safety organizations. 3. Keeps abreast of state Medicaid Managed Care changes through Healthcare and Family Services (HFS) and the Illinois Managed Health Plans Association (IAMHP). 4. Keeps abreast of changes through National Committee for Quality Assurance (NCQA).
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Qualifications
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Minimum Acceptable Qualifications
CREDENTIALS TO BE VERIFIED BY PLACEMENT OFFICER
- Eleven (11) years of progressively responsible management work experience in a private or governmental organization:
- Eight (8) years in the area of designated specialization required by the position
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- Three (3) years supervising the work of a professional staff or process within the designated specialization
- Bachelor's degree may be substituted for the above three (3) years non-specialized experience requirement
- Master's degree may be substituted for one (1) year specialized work experience
Knowledge, Skills and Abilities (KSAs)
- thorough knowledge of modern management principles
- thorough knowledge of staff utilization and motivation
- ability to plan and manage the work of subordinate supervisors and staff
- ability to formulate, recommend, and implement unit administrative policies and procedures
- ability to develop, establish, and maintain effective working relationships with public, private, and governmental offices and agencies
- ability to develop operational and program objectives within the framework of the unit's mandated function
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Supplemental Information
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If you require assistance, please contact the Office of Human Resources at hrrecruitment@siumed.edu or call 217-545-0223 Monday through Friday, 8:00am-4:30pm. The mission of Southern Illinois University School of Medicine is to optimize the health of the people of central and southern Illinois through education, patient care, research and service to the community.
The SIU School of Medicine Annual Security Report is available online at https://www.siumed.edu/police-security. This report contains policy statements and crime statistics for Southern Illinois University School of Medicine in Springfield, IL. This report is published in compliance with Federal Law titled the
"Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act." Southern Illinois University School of Medicine is an Affirmative Action/Equal Opportunity employer who provides equal employment and educational opportunities for all qualified persons without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, protected veteran status or marital status in accordance with local, state and federal law. Pre-employment background screenings required.
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