Clinical Quality Manager
New
M
Metro Vein CentersHealthcare
RemoteFull-TimeManager
Salary not disclosed
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Job Details
- Experience
- 5+ years
- Required Skills
- TableauQuality AssuranceChange Management
Requirements
- 5+ years of physician revenue cycle experience with a focus on clinical quality standards at a national level.
- 5+ years of experience leading clinical quality efforts and change management in a fast-growth environment.
- In-depth knowledge of HEDIS, CMS QPP, Advanced Alternative Payment Models (APM), Merit-based Payment Systems (MIPS), and value-based reimbursement programs.
- Ability to navigate Electronic Medical Records (EMR), Tableau, Google Sheets, and Microsoft Office.
- Associate’s degree or higher in Business, Healthcare Administration/Management, HIM, Informatics, or associated track.
- CPHQ or CHQM certification (highly preferred).
- Coding certifications such as CPC, CPMA, CCS, RHIT, or CDIP are a plus.
- Prior experience with Athena Practice (GE Centricity) EMR is a plus.
- Experience within vascular or vein-specific clinical environments is a plus.
- Clinical background as an LPN, RN, NP/PA, or FMG/IMG is a plus.
Responsibilities
- Conduct deep-dive reviews of current documentation and workflows within the electronic health record (EHR) to identify gaps in quality and compliance.
- Assist with clinical documentation training and feedback sessions for providers to ensure evidence-based standards, documentation, and coding accuracy requirements are met.
- Develop, Implement, and Monitor MVC’s pay for performance/value-based incentive programs to ensure alignment with specific payer contracts.
- Develop and analyze new and existing data reports to communicate performance trends and "red flags" to leadership teams.
- Identify opportunities for automation and software enhancements to streamline quality reporting and documentation auditing & coding workflows.
- Establish a unified clinical roadmap that aligns national clinical guidance with regulatory & payer requirements and organizational strategy.
- Build partnerships across IT, Credentialing, and Clinical Operations to ensure clinical guidance meets both business and patient needs.
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