Market Executive of Clinical Quality, Home Health
About The Position
Become a part of our caring community This is a remote role that requires travel to branch locations in Illinois and Indiana. You will report to the Director of Home Health Clinic Operations Strategy. This is a salaried position which includes participation in an annual incentive bonus plan of up to 25% of annual salary. The Market Executive of Clinical Quality, you will drive clinical quality and regulatory metrics by onsite leadership in assigned market. You will be accountable for the following: clinical and survey metrics, clinical operations metrics, claims denials, AO/state survey results, risk mitigation, clinical compliance, QAPI adherence and VBP performance. Work with area operations and branch leaders on processes, initiatives and in-scope changes or updates. Essential Functions: Improve clinical quality and regulatory metrics in assigned branches through coaching clinical managers and staff on improving care delivery and documentation requirements. Implement and monitor clinical performance of advanced clinical care programs into assigned branches. Monitor quality metrics for assigned Market; report main insights to AVP of Ops & Area Exec of Clinical Quality and other important Clinical/Ops partners. Conduct survey audits to prepare for official surveys and support locations through survey process. Conduct meaningful virtual/in-person branch interactions to improve performance. Use your skills to make an impact Knowledge/Skills/Expectations: You will be located in either Illinois or Indiana (or surrounding area). Knowledge of business management and government regulations; expertise in relevant state regulations and survey activities. Analyze medical documents, financial reports and legal documents. Coach/mentor branch leadership and clinicians to influence changes in daily clinical activities. Proactively engage to identify and address issues. Expertise in branch-level clinical workflows an organization structure. Analyze clinical data to drive important insights and opportunities. Possess strong judgement on workflow and process improvement. Influence and communicate. Strong execution capabilities. 60-90 branch in person touchpoints per year. Travel approximately 50%-75%.
Requirements
- Bachelor's Degree in Nursing (BSN)
- RN licensure in Indiana or Illinois or applicable nursing compact license
- Experience with clinical quality improvement and survey preparation
- Knowledge of business management and government regulations; expertise in relevant state regulations and survey activities
- Analyze medical documents, financial reports and legal documents
- Coach/mentor branch leadership and clinicians to influence changes in daily clinical activities
- Proactively engage to identify and address issues
- Expertise in branch-level clinical workflows an organization structure
- Analyze clinical data to drive important insights and opportunities
- Possess strong judgement on workflow and process improvement
- Influence and communicate
- Strong execution capabilities
- 60-90 branch in person touchpoints per year
- Travel approximately 50%-75%
Nice To Haves
- Five years of branch leadership (previous Branch Director/Regional Administrator with multi-site experience)
- HomeCare HomeBase (HCHB) experience
- OASIS experience
- Experience managing healthcare revenue
Responsibilities
- Drive clinical quality and regulatory metrics by onsite leadership in assigned market
- Accountable for clinical and survey metrics, clinical operations metrics, claims denials, AO/state survey results, risk mitigation, clinical compliance, QAPI adherence and VBP performance
- Work with area operations and branch leaders on processes, initiatives and in-scope changes or updates
- Improve clinical quality and regulatory metrics in assigned branches through coaching clinical managers and staff on improving care delivery and documentation requirements
- Implement and monitor clinical performance of advanced clinical care programs into assigned branches
- Monitor quality metrics for assigned Market; report main insights to AVP of Ops & Area Exec of Clinical Quality and other important Clinical/Ops partners
- Conduct survey audits to prepare for official surveys and support locations through survey process
- Conduct meaningful virtual/in-person branch interactions to improve performance
Benefits
- Humana provides medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance and many other opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Executive
