Assistant Director of Population Health and Operations

Job Description                                                                                                                                                                                                                                                                        

Title:   Assistant Director of Population Health and Operations      

Department: Population Health       

Reports to: Director of Operations   

FLSA status:  Exempt 

Last revision date: 06/19/2023

Supervises others:     Yes 

Employee Signature:            ____________________________________________                    Date: _________________   

Supervisor Signature:             ____________________________________________                    Date: _________________

Summary:  The Assistant Director of Population Health and Operations is responsible for supervising CPC’s management of quality improvement initiatives, quality care coordination team, and value-based care programs.

Quality and valued-based programs that CPC currently participates in are ACO plans, multiple Medicare Advantage programs, and CMS's MIPS/MACRA program. The Assistant Director will assist in the on the overall development, implementation, and maintenance of the organization's quality department and these programs.

The Assistant Director will use relevant clinical applications software to capture, analyze and evaluate data to prove adherence, support workflows and measure improvement. The Assistant Director will serve as a support person for corporate-wide quality initiatives.

Education:     Associate's or Bachelor’s degree in health care or related field.                        

Experience:    At least 2 years of experience in a supervising role. 

Essential Job Functions:

• Manages a clinical quality team to help carry out department and corporate goals.
• Oversees and leads improvement projects related to strategic quality improvement and reporting initiatives.
• Supports clinical teams in planning improvement activities utilizing standardized improvement methodologies and data.
• Understands policies, standards, measures, and benchmarks that the organization needs to adhere to and works with Director of Operations and IT Department to integrate software applications, resolve conflicts, evaluate and improve capturing of clinical information, and ensure smooth operation of integrated applications.
• Regularly analyzes reports on clinical quality indicators for performance improvement activities.
• Lead and attend provider and staff-level meetings to present program details, updates, and directives.

This list is not meant to be restrictive, totally inclusive, or limited in employee assignment or responsibilities.

 

Knowledge, Skills, and Abilities

• Knowledge of Electronic Health Records (EHRs)
• Proficient in Microsoft Office, including Excel, Word, and Access
• Knowledge of insurance carriers, Medicare and commercial
• Knowledge of quality incentive programs, including HEDIS measures, and shared savings programs
• Knowledge of Insurance Verification, Pre-Authorizations and Pre-Certifications
• Ability to analyze, collect, and report data to insurance payers
• Ability to identify emergent medical situations
• Demonstrate positive customer service skills
• Ability to function in a fast-paced work environment, multi-tasking
• Attention to detail

Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephone, calculators, etc.

Work Environment: Position is primarily in a well-lighted office environment. 

Mental/Physical Requirements: Stooping, turning, bending, squatting, kneeling and the ability to lift up to 50 pounds; constant/repetitive standing; requires normal, correctable vision and hearing.

 

DISCLAIMER

The above information is intended to describe the general nature and level of work being performed by people assigned to this job. It is not intended to be an exhaustive list of responsibilities, duties and skills required of personnel so classified. Examples listed do not preclude the performance of other duties similar in nature or in level of complexity.