Clinical Quality Manager
What You Will Do
- Clinical Auditing: Conduct deep-dive reviews of current documentation and workflows within the electronic health record (EHR) to identify gaps in quality and compliance.
- Provider Education: Assist with clinical documentation training and feedback sessions for providers to ensure evidence-based standards, documentation, and coding accuracy requirements are met.
- Quality Performance Monitoring: Identify all qualifying opportunities, and Develop, Implement, and Monitor MVC’s pay for performance/value-based incentive programs to ensure alignment with specific payer contracts.
- Data Reporting: Develop and analyze new and existing data reports to communicate performance trends and "red flags" to leadership teams.
- Process Engineering: Identify opportunities for automation and software enhancements to streamline quality reporting and documentation auditing & coding workflows as the practice grows.
- Clinical Quality Leader: Establish a unified clinical roadmap that aligns national clinical guidance with regulatory & payer requirements and organizational strategy. Ensures clinical operations are within regulation and meet the highest level of quality.
- Stakeholder Liaison: Build partnerships across IT, Credentialing, and Clinical Operations to ensure clinical guidance meets both business and patient needs.
Minimum Qualifications
- Expertise: In-depth knowledge and experience with Healthcare Effectiveness Data and Information Sets (HEDIS), CMS Quality Payment Programs (QPP), Advanced Alternative Payment Models (APM), Merit-based Payment Systems (MIPS), and payer specific Quality Initiative Value-Based Reimbursement programs.
- Technical Literacy: Ability to navigate Electronic Medical Records (EMR), data reporting (Tableau), and Google Sheets/Microsoft Office systems efficiently.
- Experience: 5+ years of physician revenue cycle experience with a focus on clinical quality standards at a national level.
- Leadership: 5+ years of experience leading clinical quality efforts and change management in a fast-growth environment.
- Education: Associate’s degree or higher in Business, Healthcare Administration/Management, HIM, Informatics, or associated track.
Preferred Qualifications
- Certifications: CPHQ or CHQM highly preferred. Open to other relatable certifications.
- Coding Expertise: CPC, CPMA, CCS, RHIT, or CDIP certifications are a significant plus.
- Systems: Previous experience with Athena Practice (GE Centricity) EMR.
- Specialty: Experience within vascular or vein-specific clinical environments.
Benefits to Support Your Wellbeing & Lifestyle
- Medical, Dental, and Vision Insurance
- 401(k) with Company Match
- Paid Time Off (PTO) + Paid Company Holidays
- Company-Paid Life Insurance
- Short-Term Disability Insurance
- Employee Assistance Program (EAP)
- Career Growth & Development Opportunities
Legal & Compliance Notice
Metro Vein Centers complies with all applicable federal, state, and local employment laws, including those related to nondiscrimination, equal opportunity, and pay transparency. Where specific disclosures or postings are required by law, we provide this information as part of our hiring process or upon request.
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