Clinical Performance Advisor

Responsibilities

• Represent SCP Health, patient services, and the Hospital to ensure retention of existing referral sources, grow new referrals and volumes by enhancing client, PCP, Patient and Provider Satisfaction, as well as Quality Case Management, Emergency Department, and other facility relations.
• Support training coordination and orientation process of new office staff, and all patient care providers including, but not limited to, maintaining current orientation packets, obtaining computer access and any facility specific training.
• Participate in physician interviews and coordinate with the Staffing Operations team to ensure applicants meet with the medical directors and tour all facilities of interest.
• Act as a professional representative in dealing with all levels of hospital and staff personnel and promote communication within the hospitalist team and with hospital staff, patients/families, caregivers, administration, nursing staff, referral sources, care management, and SCP Health corporate team members.
• Serve in support of the Medical Director as point person and liaison for the program.
• Maintain and cultivate collaborative relationships with key personnel.
• Monitor onsite performance, operational challenges, and share recommended strategies for improvement and efficiencies to the VP of Clinical Performance Improvement and the Field Operations teams.
• Oversee daily practice operations and support the needs of the program related to physician engagement, facility initiatives and priorities.
• Lead and support daily workflows designed to drive clinical performance initiatives.
• Recommend and implement improvements to the practice as it relates to KPI’s, and Client & Provider Satisfaction as established by both the SCP Health and client teams.
• Collaborate with the SCP Field Operations team, Medical Director, establish and facilitate standing HM Committee meetings between Hospital Administration, designated facility department managers, and SCP Health HM representatives (include ED representatives if contract includes both).
• Facilitate engagement with Medical Director(s) to result in meeting participation, provider recruiting and retention.
• Availability by phone or pager for emergencies, patient complaints, high-risk patients or situations and all practice support functions.
• Work with hospital administration to attain the group’s key clinical and practice indicators relating to quality, core measures, readmission rates, length of stay, case mix index (CMI), billing/diagnostic coding trends, and daily volume statistics.
• Meet regularly and assist Medical Director and Field Operations team in development of clinical protocols, order sets, workflows, best practices, engagement, etc.
• Ensure completion of all site-specific requirements.
• Participate in required corporate meetings, training sessions, organizational pilot programs, and cross coverage as requested.
• Support value-based care goals and data/information sharing requirements.

Qualifications

• Knowledge of Medicare, Medicaid, and Marketplace lines of business and applicable regulatory requirements.
• Intermediate knowledge of healthcare informatics, including clinical quality measures.
• Working knowledge of staff development and the educational process, quality improvement, continuous process/performance improvement methodology, preferred.
• Demonstrated ability to plan, coordinate, and evaluate Quality Assurance (QA) and Performance Improvement (PI) activities, preferred.
• Understanding of financial and budgeting processes and principles.
• Ability to build effective partnerships within the organization to collaboratively execute business strategies.
• Effective oral and written communication skills.
• Ability to work effectively in a matrixed organization.
• Intermediate Microsoft Office proficiency (i.e., Outlook, Excel, and PowerPoint).
• Bachelor’s degree in nursing, or healthcare relevant field required.
• Master’s degree, preferred.
• 5+ years’ experience as a clinician in an acute healthcare setting.
• 3+ years of clinical quality assurance, data analytics and reporting experience in a managed-care setting.
• Prior case management experience.
• Direct patient care experience, ICU/EM experience, preferred.
• Experience with hospital-based and outpatient clinical quality measures, strategies, and reporting.
• RN certification, required.

Pay

Pay Range: 75,280.00 - 111,435.00 USD annually

This range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations.

We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources.

Visit our website for further information.