National Director of Quality Improvement

About us:

HEART. It is the driving force of our commitment to serving others with empathy, respect, and dignity. CareMax, is committed to providing the best that medicine has to offer with quality healthcare for those who need it most, our seniors. Join our team and experience it for yourself. We are Health with Heart.

About you:

The Director of Quality Improvement & Stars, MSO is responsible for many of the activities needed for reaching the organization’s quality goals. The Director is responsible for defining, implementing, and monitoring the MSSP MIPS, HEDIS and Stars data collection; identifying and prioritizing provider practices that can most impact overall performance; defining specific action plans per region and practice as applicable; evaluating the performance monthly; and evaluating the QI team performance and reassigning tasks as needed. The QI Director works under the leadership of the VP, Quality Improvement & Stars to develop strategies for improving the patient experience. The QI Director is responsible for reviewing, understanding and keeping CareMax leaders updated on regulatory and reporting requirements for MSSP quality metrics. This role leads the quality data tracking and report preparation to efficiently and effectively monitor and achieve CareMax performance goals. The Quality Director supervises a team of nonclinical staff who promote and facilitate that the CareMax patients complete needed preventive and clinical care services, coordinates the education of providers regarding quality metrics, processes and reports. The Quality Director will maintain an effective relationship with the Provider Relations and Operations leaders department in order to ensure an excellent performance from associated centers.

Essential Duties and Responsibilities:

• Plans, directs and supervises the duties and performance of all QI Department, MSO staff
• Establishes strong working relationships with health plan Quality Department representatives to ensure that reports and data are received on a timely basis in an agreed-upon format
• Maintains a strong working relationship with the Provider Relations department and Operations leaders
• Reviews and summarizes MSSP regulatory and reporting requirements for quality metrics and informs leadership
• Leads the strategic planning to identify MIPS measures of focus
• Ensures that the accuracy of the data in the MIPS, Stars and HEDIS databases and the timely delivery or MIPS, Stars, health plan and practice-level scorecards
• Ensures the timely and accurate submission of MIPS data to CMS
• Meets regularly with the Provider Relations and Operations leaders to review performance and create specific action plans, and ensure the timely delivery of medical records to achieve the maximum quality performance. Meets with pertinent practice administrators
• Provides leadership, support and training updates for staff that perform medical record review and data entry into the CareMax Quality Department
• Collaborates with the Coding and Billing Department to ensure that there are processes in place for the coding of HEDIS-related diagnoses and CPT codes
• Assists and supervises the quality educator in the development and implementation of training and education on MIPS and STAR/HEDIS measures to QI staff, Provider Relations department and Operations leaders, providers and office staff
• Collaborates with the patient experiences teams to create strategies for improvement in internal and health plan patient surveys
• Provides support to the patient experience teams in the training of and performance review meetings with the Provider Relations department and Operations leaders
• Participates in hiring staff and ensures effective on-boarding strategies for staff
• Supervises collection of supplemental data and submits to the health plans to close remaining gaps
• Perform other duties as requested

Qualifications/Experience

• Minimum 3 years of MIPS and HEDIS/Quality experience with acquired progressive responsibility
• Undergraduate degree required
• Strong leadership and organization skills with the ability to achieve priorities, measurements, and strategic goals with limited/minimal supervision
• In depth knowledge of MIPS, Stars metrics, HEDIS specifications, CAHPS and HOS
• Knowledge and working experience with ICD10CM, CPT-4 and HCPCS official coding guideline
• At least 3 years of experience in managing and monitoring continuous improvement activities and/or projects, including and not limited to tracking key performance indicators
• Proficient knowledge of computers and typical production software (e.g., MS Office, Outlook, Word, Excel, PowerPoint, etc.
• Experience and proficiency with different electronic medical record systems
• Ability to travel as needed throughout the United States, including and not limited to driving between site locations and air travel
• Ability to supervise staff working at multiple sites throughout the organization
• Strong interpersonal skills to allow relationship building with other leaders and provider
• An energetic, ambitious and dynamic personality

Come join the CareMax family and be part of Health with Heart. Help us continue to change lives every day!

CareMax provides equal employment opportunity to all applicants and employees. No person is to be discriminated against in any aspect of the employment relationship due to race, religion, color, sex, age, national origin, disability status, genetics, citizenship status, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws