The Vice President Clinical Excellence is a key member of the Clinical leadership team. The VP develops, implements, and leads clinical quality, patient safety, clinical compliance, and delegation program management efforts that support the entire organization across all markets and lines of business. This leader is also responsible for the development and implementation of organization-wide clinical policies and oversees implementation to ensure consistent care. The VP supports the development of programs and approaches to ensure quality and consistency of clinical pathways, programs and services across markets This position has direct leadership responsibility for the team who develops, manages, and oversees policies, programs, and clinical performance improvement activities across the organization.

RESPONSIBILITIES

Patient Safety

• Leads identification, investigation, root cause analysis, and risk mitigation efforts related to patient safety occurrences and near misses
• Analyze data at the patient, provider, and panel level to identify trends and develop interventions to produce better outcomes
• Creates a culture of learning and teaching among the care teams and with patients.

Quality of Care

• Collaborates with Population Health, ConcertoCare Operations, and local market leaders to develop and implement consistent clinical quality improvement processes to ensure consistent care and access for all markets and products. Leads Quality Improvement Opportunity (QIO) efforts with market leaders.
• Works in collaboration with clinical and population health leaders to prioritize, research, develop and integrate Quality and Safety procedures and clinical best practice standards across the organization to support safe and efficient patient care
• Develops and manages organizational Clinical Quality program and strategy
• Leads clinical pathway and clinical practice quality audits. Establishes and supports clinical audit processes, tools and tracking to be used for staff oversight in partnership with Market Medical Directors, Population Health Leaders, and Nursing Leaders across the organization
• Collaborates with market leaders to implement, monitor, and drive performance improvement of clinical care and quality programs based on care pathways and clinical quality audits in the organization.
• Identify opportunities for practice improvements configured for products and markets, pilots, and tests new approaches, institutionalizes proven practices across the organization

Clinical Compliance

• Monitors and ensures compliance with state, federal and accreditation body clinical practice standards
• Identifies areas of clinical policy variation across the organization, leads development of consistent policies, and facilitates market-configured procedure development to drive consistent implementation of policies
• Partners with Legal and Corporate compliance to develop collaborative practice agreements that meet state requirements for APPS in each market. Monitors and oversees CPAs across the organization to ensure compliance requirements are met.
• Partners with market Medical Leaders to ensure that collaborative practice oversight procedures and requirements are understood and adhered to by the market clinical leadership.
• Researches, determines, maintains and updates clinical scope of practice requirements for each market, and establishes organizational policies and procedures to ensure compliance and organizational consistency
• Provides clinical resource and support for Critical incident monitoring
• Partners deeply with Compliance team to proactivity identify and address clinical practice or regulatory risks through mitigation plans and monitoring
• Leads and supports ConcertoCare’s Clinical Review Board, both in identification and management of key topics and information, and in the follow up and tracking of actions related to decisions of the Board.
• Provides staff education and training related to clinical compliance topics

Delegation Administration

• Leads organizational delegation management efforts, including assessment of delegation requirements for specific oversight bodies, response to pre-delegation and ongoing delegation surveys
• Oversees development of policies and procedures designed to meet requirements of regulatory bodies such as NCQA, CMS, and other
• Leads delegation audit responses and oversees coordination of audit activities
• Ensures that all reporting and compliance tracking activities are implemented in accordance with regulatory body requirements

QUALIFICATIONS

• Licensed Registered Nurse.
• Bachelor’s Degree in healthcare or business
• Master’s degree in Business, Healthcare, or related discipline
• Quality and Safety certifications such as CPHQ and/or CPPS strongly preferred
• 7 plus years healthcare experience
• 2+ years ambulatory provider or home-based care experience
• 3+ years program implementation experience
• 3-5 years team and program leadership experience required
• 2+ years value-based care experience
• 2+ years clinical compliance, risk management, medical staff and or peer review
• Working knowledge and experience with healthcare financing models such as Medicare, Medicaid, SNP strongly preferred. Payer experience is a strong plus
• Demonstrated success working in matrixed organizations, and leading through indirect reporting models
• Demonstrated success with both leadership and “roll up your sleeves” roles

Base Salary/ Wage Range $165,000-$175,000 plus annual bonus. Compensation for the role is commensurate with the candidate’s qualifications, skills, competencies, and experience and may fall outside of the range shown. ConcertoCare offers a competitive total rewards package, which includes full healthcare coverage, a 401K with match, and a broad range of other health, wellness, and financial benefits.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. ConcertoCare is an Alcohol/Drug/Smoke-Free Workplace.