Employment Type:

Full time

Shift:

Description:

The Regional Director of Care Management and Quality is responsible for the overall development and implementation of population health care management and quality improvement strategies across the MercyOne PHSO Partnered Provider Network.

Regional Director Care Management and Quality      

Reporting to: PHSO President

Supervisory Responsibility: Yes

FLSA Status: Exempt, salaried  

Department:  MercyOne System Office, Population Health Services Organization

Effective Date: 01/2025

Mission Statement: MercyOne serves with fidelity to the Gospel as a compassionate healing ministry of Jesus Christ to transform the health of our communities.

MercyOne Vision Statement:

MercyOne will set the standard for a personalized and radically convenient system of health services.

MercyOne Cultural Beliefs:

Be ONE

I benefit from and strengthen MercyOne.

Personalize Care

Your experience.  My responsibility.

Own It!

I own my actions to deliver our key results.

Improve Daily

I make improvements every day for those we serve including each other.

Innovate

I imagine and embrace bold new ideas to revolutionize health.

         

Job Summary: The Regional Director of Care Management and Quality is responsible for the overall development and implementation of population health care management and quality improvement strategies across the MercyOne PHSO Partnered Provider Network. As a member of the PHSO Leadership Team, the Director provides oversight/leadership to care management program managers and their respective regional teams, including the areas of acute, post-acute, ambulatory care, pharmacy and quality management. He/she will be responsible for clinical and performance outcomes in value/risk-based arrangements focusing on clinical, cost and quality processes and outcomes. The Director will work collaboratively with regional market Executive(s), PHSO governance groups, regional Medical Directors, Medical Group, Acute Case Management Leaders, Community Health and Wellbeing (CHWB), Pharmacy and Emergency Department (ED) Leaders on corporate strategic initiatives to achieve the desired outcomes that support value based/risk contracts.

Essential Position Expectations:

Provides oversight/leadership to regional (multi-state) care management operations and quality management programs that support value based processes and outcomes. Responsible for clinical and quality performance and financial targets/outcomes in value based contracts. Responsible for resource allocation and budgeting of Care Management and Quality staff. Engages with MercyOne PHSO Chief Medical Officer, Medical Directors, PHSO governance groups, Medical Group, Acute Case Management Leaders, CHWB, and ED Leaders on a routine basis for program/strategy design to ensure optimal performance under value/risk-based contracts. Oversees new accreditation initiatives and maintains existing PHSO accreditations related to delegated service arrangements. Leads strategic initiatives across the PHSO Network including the areas, but not limited to, care management and quality improvement. Maintains and develops on-going education and training programs focused on effective population health care management. As necessary, represents MercyOne PHSO in payer, consortium, and employer meetings. Participates as a member of the MercyOne PHSO Leadership team, on related governance structures and supports regional chapter governance meetings Responsible for leading statewide Clinical Integration Council and maintaining clinical best practices for population health and care management to ensure provider engagement for success under value/risk-based care. Works collaboratively across the organization on care model development. Maintains a strong collaborative relationship with market operations leadership including the areas of Acute, Ambulatory, Post-Acute and Ancillary services. Collaborates with PHSO Analytics team to oversee care management data platform to manage population health initiatives and to measure and track outcomes. Interpret advanced population health analytics to inform care management and quality programs. Work collaboratively with CHWB team to identify and manage at risk populations and SDoH initiatives. Prepares business plans, proposals, special projects and presentations as requested. Oversee all quality reporting, including but not lim