Summary:

The Director of Quality and Population Health is responsible for oversight of the Quality Program and ensuring that the Annual Quality Improvement Work Plan is developed, executed and evaluated. The Director of Quality and Population Health is responsible for continuous monitoring of key metrics to ensure that Quality Improvement (QI) activities are sustained. The Director of Quality and Population Health provides strategic and operational leadership to the performance measurement /reporting / improvement initiatives of Borrego Health that align with emerging national and state requirement opportunities. The Director of Quality and Population Health is responsible for resolving quality-related issues, ensuring completion of QI activities and overseeing staff training in QI methodology. The Director of Quality and Population Health serves as Chair of the Quality Committee and is responsible for bringing to the Committee any items that require attention. The Director of Quality and Population Health in conjunction with the Chief Compliance Officer also provides regular CEO and Board of Trustees reports consisting of:

• 
  Metrics identification
• Metrics measurement relative to pre-established goals or quality action points (i.e.: Hedis, UDS, FTCA PI projects)
• Initiation of quality improvement activities
• Periodic updates on quality improvement activities

The Director of Quality and Population Health is also responsible for communicating results of quality improvement activities internally. This includes sharing information about progress and resolution of quality problems identified through ongoing monitoring activities. Finally, the Director of Quality and Population Health is responsible for helping create a culture that celebrates significant achievements in quality improvement and acknowledging staff who contribute to identifying issues and making the improvements.

Key Objectives

Ø Ensures quality care to the patients of Borrego Community Health Foundation, within the scope of practice outlined by state or federal law.

Ø Ensure that care is delivered in accordance with established standard of care and accepted community standards

Ø Understands the organizations commitment to provide high quality patient care. Promotes a Patient centered environment.

Ø Contributes to PCMH by continually focusing on patients’ health status and outcomes and working towards improvements in both.

Essential Duties and Responsibilities:

Quality

1. Provide leadership in the design and implementation of leading edge strategies that align measurement and improvement initiatives with emerging national and state requirements.

2. Direct and supervise assigned personnel, including performance evaluations, scheduling, orientation, and training. Make recommendations on employee hire, transfer, promotion, wage change, discipline, termination, and similar actions.

3. Coordinates and oversees data collection and analysis, reporting, improvement activities, and follow-up activities.

4. Collaborates with leadership to define goals and objectives of the different department heads, when it comes to department specifics quality improvement activities.

5. Chairs the Quality Committee and works with the committee members to establish performance improvement priorities.

6. Leads the development of Borrego Health policies and procedures related to quality improvement and participates as a stakeholder in the constructing of Borrego Health’s policies.

7. Develops long-range goals, annual objectives, and strategies for areas of responsibility.

8. Serve as principal spokesperson for Quality. Communicate the mission and implementation of quality activities.

9. Engage regional medical directors, medical staff and staff in performance improvement activities.

10. Ensure comprehensive in-service education and training is in place to continually support enhancement of operational effectiveness of quality programs and services.

11. Be a full partner with other members of management in solving problems.

12. Create opportunities to celebrate the accomplishments of staff, physicians and peers.

13. Works on a collaborative basis with other members of the executive team.

14. Other duties as assigned.

Population Health

1. Assists the CCO in designing the population health strategy for Borrego Health and in implementing that strategy.

2. Focuses on disease trends and risk factors and designs programs to identify those factors

3. Helps define those specific population subgroups that are outliers on cost and outcome metrics and defines the changes to their care processes that will improve those metrics.

4. With others in the organization, designs educational programs for these populations to enable clinical teams prevent and/or manage disease processes.

5. Accesses, analyzes, and when appropriate, uses Borrego’s data regarding demographics, health status, diagnoses, services, costs, and reimbursement across the care continuum.

6. Assists in the development and use of baseline measurements of treatment costs and outcomes over time.

7. Carefully tracks clinical interventions, costs, patient compliance, patient satisfaction, and real-life outcomes (such as patients’ return to work, productivity, and activities of daily living).

8. Evaluates the impact of clinical interventions.

9. Collaborates with payers, community organizations, and advocacy groups

10. Since Borrego does not own all the components of the care continuum for the selected populations, helps develop affiliations and partnerships with other providers and organizations.

11. Communicates progress to all levels of Borrego Health.

12. Helps create a feedback loop that informs all stakeholders regarding plans, activities, and results.

13. Other duties as assigned.

Qualifications:

Minimum Qualifications:

1. Clinical background and experience in Federally Qualified Healthcare Systems in Quality (UDS, Hedis, FTCA and HRSA) Bachelor’s degree, Master’s degree preferred.

Knowledge, Skills and Abilities:

1. Strategic, opportunistic, and entrepreneurial thinker.

2. Ability to articulate a vision for measurement, develop, and sustain multi-stakeholder collaboration in support of the vision.

3. Possesses a tolerance for ambiguity and inter-organizational complexity.

4. Ability to quickly assimilate, assesses, and act upon new concepts, trends, and initiatives.

5. Baseline understanding of health information technology (HIT) / health information exchange (HIE), including data networks, database management and operating systems and interfaces.

6. Excellent organizational skills with the ability to manage multiple tasks.

7. Understanding of clinical and business processes and improvement methods.

8. Effective group / project management skills.

9. Excellent verbal and written communication skills.

10. Ability to understand basic quantitative concepts.

11. Ability to analyze complex tasks, systems, problems and determine solutions.

12. Effective interpersonal skills.

13. Leadership skills, comfortable with decision-making responsibilities.

14. Proficient in coaching, teaching, and counseling skills.

15. Ability to inspire and build confidence in others and to forge alliances and garner support.

16. Analytical ability to conceptualize well in unstructured, dynamic, and/or multidisciplinary environments requiring analysis, as well as a thorough knowledge of fundamental quality principles.

17. Ability to exercise complete discretion in how and what to communicate.

18. Project management skills, including the ability to define program project or process objective, identify stakeholders, plan steps, coordinate and allocate human, technological, and fiscal resources to accomplish goals and objectives in a resourceful and timely manner.

Physical and Mental Requirements:

1. Able to lift/move up to 40 pounds, move from place to place, and stand for long periods of time

2. Ability to do math, organize and prioritize workload, work effectively and efficiently under stress

3. Ability to supervise, multitask, understand and follow instructions

4. Ability to proficiently read, write, speak and understand English

Customer Service:

1. Actively supports, promotes, and works to fulfill the Mission, Vision and core values of Borrego Health.

2. Provides excellent internal and external customer service.

3. Demonstrates Borrego Health’s Standards of Customer Service Behavior: Compassion, Attitude, Communication, Appearance, Sense of Ownership, and Teamwork.

4. Participates in on-going customer service trainings.

5. In every action, seeks to promote Borrego Health as a top service organization.

Quality Management:

1. Contribute to the success of the organization by participating in quality improvement activities.

2. Complies with all Borrego Health policies and procedures and pro-actively participates in the implementation of new initiatives.

Safety:

1. Ensures compliance with policies and procedures related to safety.

2. Uses all appropriate equipment and/or tools to ensure workplace safety.

3. Immediately reports unsafe working conditions.

Privacy/Compliance:

1. Maintains privacy and security of all patient, employee, and volunteer information and access to such information. Such information is accessed on a need to know basis for business purposes only.

2. Complies with all regulations regarding corporate integrity and security obligations. Reports unethical, fraudulent or unlawful behavior or activity.

3. Upholds strict ethical standards

Flexibility: Available for all shifts and, when required, able to work evenings and weekends.