Director - Clinical Provider Performance Projects - Health Alliance Plan (HAP)

GENERAL SUMMARY: Under the direction of the Vice President, Revenue Management and Risk Adjustment the Director of Clinical Provider Performance Projects will lead initiatives to design and implement HAP risk sharing Independent Practice Association (IPA) performance improvement projects. The Director will have a deep understanding of government programs and clinical best practices for integrated care models serving members with chronic conditions and complex care needs. The Director will work across HAP, Henry Ford Health System & Non-Ford risk sharing provider organizations to optimize data and implement clinical protocols that are designed to improve physician service value, member health, satisfaction. Key responsibilities include developing and implementing a systematic yet agile approach to integration of care across physician services, that targets high cost, high risk members with HCC and HEDIS/quality gaps in care.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

·        In partnership with risk sharing IPA clinical leadership designs, implements and monitors value based outpatient clinic services for HAP membership.

·        Assists with the management of the day to day activities to improve outpatient clinic operations.

·        Accountable to maximize strategic initiatives to achieve a high level of clinical integration and standardization of work processes, policies/procedures, administrative processes, and other necessary efforts to maximize efficiency and effectiveness of the program.

·        Works with IPA and HAP population health, medical analytic teams for development and refinement of IPA practice transformation strategies.

·        Uses improvement methodologies (Plan Do Study Act, Lean) to lead teams in quality and risk adjustment improvement.

·        Understands requirements of Joint Commission, HRSA, NCQA and assists in assuring compliance with the standards involving population health, risk adjustment and quality improvement.

·        Demonstrates high level skill in navigating successful relationships with IPA clinical leadership and staff as well as across HAP leadership and staff.

·        Completes annual employee health requirements within established timeframes.

·        Maintains license/certification, registration in good standing throughout fiscal year.

·        Direct patient care providers are required to maintain Basic Cardiac Life Support (CPR) and other certifications as required by position/department.

·        Currently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.

·        Adheres to regulatory agency requirements, survey process and compliance.

·        Complies with established organization and department policies.

·        Ensures appropriate analytics are properly utilized related to analyzing opportunities, implementing changes and tacking results.

·        Interacts regularly with business units and Corporate/System Senior Leaders as clients and principal decision makers about clinical project management functions. Works collaboratively with administrators, managers and physicians on projects within their areas.

·        Serves as a change agent within HFHS, supporting both the identification and application of new clinical project management concepts and driving the spread of best practices throughout the System.

·        Performs other related duties as assigned.