RiverStone Health-posted 8 days ago
Full-time • Mid Level
Billings, MT
251-500 employees

The Clinical Quality Program Manager will lead and oversee the development, implementation, and ongoing evaluation of clinical quality initiatives across our Federally Qualified Health Center (FQHC), which is recognized as a Patient-Centered Medical Home (PCMH). This position plays a critical role in advancing the organization’s mission to provide high-quality, equitable, and patient-centered care to underserved and diverse populations. The Clinical Quality Program Manager will be responsible for designing and executing strategies to enhance clinical outcomes and population health to improve patient experience, and ensure compliance with regulatory and accreditation standards, including HRSA, UDS, PCMH, and NCQA guidelines. This role involves close collaboration with medical, nursing, behavioral health, dental, and administrative leadership to foster a culture of continuous quality improvement (CQI), evidence-based practice, and data-driven decision-making. Key responsibilities include leading quality improvement initiatives and projects, managing clinical performance metrics, ensuring timely and accurate reporting for internal and external stakeholders, and guiding the organization in achieving excellence in care coordination, chronic disease management, and population health outcomes. The Clinical Quality Program Manager will champion universal care delivery, leveraging health information technology, informatics and data analytics to reduce disparities and enhance outcomes across the full spectrum of services provided by the health center. This leader will also oversee quality improvement staff and play a key role in provider engagement, education, and performance feedback.

  • Oversight of all clinical quality including monitoring, validating, improving and reporting.
  • Ensure computerized record management systems are adequate, communicate IT issues and recommend improvements.
  • Ensure confidential information is safe guarded.
  • Plan, implement, and administer projects and other quality improvement initiatives.
  • Maintain awareness of advances in equipment, IT software, data processing, government regulations and financing options.
  • Monitor the use of equipment, inventory, facilities and other program resources that affect services provided, including those internal and external to RiverStone Health.
  • Manage change in integrated health care delivery systems, such as work restructuring, technological innovations, and shifts in the focus of care.
  • Maintain communication between staff, leadership and other stakeholders by attending meeting, and coordinating interdepartmental functions, maximizing effectiveness and efficiency of interdepartmental operations.
  • Establish objectives and evaluative operational criteria.
  • Develop, implement, and ensure adherence to policies and procedures.
  • Review and analyze facility activities and data to aid planning, risk management and to improve service utilization.
  • Prepare activity reports to inform management of the status and implementation plans of programs, services, and quality initiatives.
  • Manage and lead complex programs and services utilizing effective communication, knowledge, resources, and business processes maximizing customer service.
  • Consult with medical, business, and other local community groups to discuss service problems, respond to community needs, enhance public relations, coordinate activities and plans, and promote RiverStone Health programs.
  • Develop Quality improvement instructional materials and conduct in-service and community-based educational programs.
  • Coordinate the operational implementation of EHR and Information System changes as they relate to clinical processes.
  • Ensure compliance with all relevant grant requirements including, but not limited to, the Health Resources and Services Administration (HRSA) Operational Site Visit Protocol, FTCA requirements, and NCQA Requirements as related to quality improvement.
  • Attend meetings, conferences, workshops, and training sessions to become and remain current on developments in areas surrounding quality improvement, project management and community health centers.
  • Oversees the management and effective implementation of Value Based Care and insurance Payor Contracts.
  • Lead and facilitate the Project Management process in the health center, to ensure adherence to established priorities and appropriate resourcing for successful project implementation. Including multiple concurrent projects with teams of 3 – 20 members.
  • Support and encourage innovation from all levels of staff while balancing available resources.
  • Lead when appropriate and activity participate in RSH projects and committees.
  • Ensure adherence to a robust Quality Improvement Program and culture, including implementation of a board-approved Quality Improvement Plan and associated procedures, guidelines and education.
  • Actively engage in personal and professional development in Quality Improvement, Project Management, Informatics and other relevant topics, actively identifying and completing self-education as well as recommending and facilitating education for CHC leadership and staff.
  • Research, implement and manage population health activities that lead to improved patient care, experience, and safety.
  • Collaborate and share quality improvement practices throughout the state with other health centers.
  • Ensure that efforts for improvement include a focus on health equity, and that potential disparities in care are addressed.
  • Champion the adoption of new technologies and practices that support the CHC’s commitment to high-quality care.
  • Perform other duties as assigned in support of RiverStone Health’s mission and goals.
  • Three years of related Health care experience in a quality improvement role, including leading teams.
  • Project management experience.
  • Proficiency in data analysis, informatics, and electronic health systems (EHR).
  • High School Diploma or equivalent
  • Any combination of experience and training which provide the equivalent scope of knowledge, skills, and abilities necessary to perform the work.
  • Valid Montana State Driver’s License
  • Lean/Six Sigma Yellow Belt (must achieve within 1 year of hire)
  • Computer literacy, in Microsoft Office Suite.
  • Ability to maintain a calm and positive demeanor during difficult interactions.
  • Ability to display non-judgmental and empathetic listening skills.
  • High degree of detail-oriented skill level.
  • Knowledge and understanding of protected sensitive patient health information (HIPAA) and confidentiality.
  • Educate staff and show through example, the significance and meaning of working collaboratively to maintain a positive work environment.
  • Ability to perform job duties with integrity and innovation to ensure completion and a high level of quality.
  • Ability to understand and adhere to required administrative policies and procedures.
  • Excellent communication skills to ensure efficiencies and quality customer service.
  • Bachelor’s degree in a related field
  • Experience in health care operations and federally qualified health center preferred.
  • Experience working with underserved population
  • Medical Terminology
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