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Vice President of Clinical Quality/Patient Safety in Boston, MA at Beacon Health Options

Date Posted: 1/14/2019

Job Snapshot

Job Description

The Vice President of Clinical Quality/Patient Safety will be responsible for building relationships across Clinical Management, Provider Network Quality, Provider Relations and other departments to enhance the services Beacon members receive.  The VP will develop a vision for improving clinical quality and enhancing member experience through various policies, programs, and interventions.  The VP also will strategically assess quality of care through data and analytics and will work with multiple stakeholders to make demonstrable improvements using various levers within the clinical quality framework.

Individual can be based remotely.

Position Responsibilities:

  • Utilizes clinical quality expertise to serve as a liaison to clinical areas, working closely with the clinical management department to improve the quality of services members receive.
  • Partners with clinical management to develop clinical quality strategy and quality management functions.
  • Works with clinical management and supports the design of measurement and evaluation techniques for assessing the effectiveness and efficiencies of the utilization and clinical management processes.Recommends opportunities for improvement and quality indicators to measure alignment with policies and procedures.
  • Develop and participate in the implementation of strategic training programs for network providers related to areas for clinical quality and patient safety.
  • Develop tools to assess performance of provider network and ensures smooth technical transfer of the tools to regions.
  • Develops reporting mechanisms for regions to report results to Corporate Quality, aggregates results, and analyzes data; continuously performs plan-do-study-act methods of QI to enhance the quality of network providers and services.
  • Assists in implementing changes to services, performance specifications, MNC based on assessments and opportunities for improvement.
  • Participates in developing measurement strategies for access and availability and identify opportunities for improvement that focuses on geographic variables that impact aftercare.
  • Work with the aftercare team to strategize assisting members with follow-up visits.
  • Works with Product Team and Network Strategy to develop initiatives such as technological strategies, i.e. telehealth that improves access/availability and supports improving HEDIS rates.
  • Enhances Beacon’s knowledge of member experience through surveys and other methodologies that lead to improving services and satisfaction.
  • Assists clinical management in improving provider satisfaction with UM processes
  • Leads the implementation of the provider survey and reporting.
  • Disseminates clinical practice guidelines and medical record review alignment and methodology.
  • Develops two screening programs annually and measures effectiveness and reports.Develops regional strategy for adopting programs and aggregates data for analysis.
  • Analyze network quality from medical records and design communications with providers about best practices.
  • Work with PQ to communicate opportunities for improvement, set new benchmarks, and continue to audit performance.
  • Assist network provider quality with areas related to care coordination, continuity of care, and behavioral health/medical integration.
  • Aggregate Quality of care issues and analyze trends and inform corporate quality strategy for improving clinical quality.
  • Participates in Beacon’s substance use disorder strategy.
  • Develops self-management tools and strategies to test and disseminate them.
  • Perform other duties as directed.

Position Requirements:

Education: Master’s degree in mental health or substance abuse services preferred.  Or, Master’s level education in public health, business, epidemiology, healthcare policy, or other relevant field.

Relevant Experience: At least ten (10) years of progressively responsible professional experience in a relevant combination of managed care, Quality Management and Clinical practice, including significant experience developing and producing reports based on analysis and interpretation of clinical and quality data.

In addition to the professional experience above, at least another five (5) years of experience managing and developing a professional staff.

Knowledge, Skills & Abilities:

  • Nuanced understanding of the interrelationship between Clinical, Network, and Quality
  • System-level approach to improving clinical quality through intervention design
  • Works well across teams with excellent communication skills, both verbal and written.Excellent business writing skills.
  • Strong leadership skills
  • Innovative in project design and proven track record in project management.
  • Data visualization and dashboard development
  • Proactively implements corrective action plans and measures improvement; able to achieve buy-in from multiple stakeholders.
  • High level of presentation skills and ability to communicate complex measurement and quality improvement design.
  • Exhibits a high level of strategic and critical thinking.
  • Strong communication skills, both oral and written
  • Strong presentation skills
  • Proficient with Microsoft Office, Excel, PowerPoint, Visio

TO APPLY

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Beacon Health Options company is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

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