Director, System Clinical Quality Performance
Job Description
About UPMC:
A $29 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates more than 100,000 employees, 40 hospitals, 800 doctors’ offices and outpatient sites, and a 4.1-million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. UPMC offers a seamless experience for patients across a continuously expanding geographic footprint. This combination of capabilities means that we can deliver the high-quality care our patients need, when and where they need it. Over the years, UPMC has invested more than $1.5 billion in technology to support clinical excellence and administrative efficiency. Our unique payer-provider structure aligns economic incentives and allows us to invest in new models of patient-centered care.
Learn more about UPMC by visiting: UPMC.com.
About the Position:
Reporting to the Vice President of Clinical Performance and Integration, the Director, System Clinical Quality Performance will oversee quality functions at the system level within UPMC. The Director will establish strategic initiatives, develop quality priorities, align quality analytics, and facilitate collaboration across our network of hospitals. The successful candidate will be a proactive and highly motivated leader with strong change management, data analytics and data visualization skills. The Director must approach this role with an innovative lens and will play a key role in transitioning all UPMC hospitals to Vizient.
Select Responsibilities:
- Formulate and implement comprehensive quality strategies aligning with local and organizational goals. This includes seamless collaboration with local quality teams and acting as the primary liaison with coding, billing, and finance departments.
- Oversee and analyze internal and external performance benchmarks to identify areas of improvement. Identify opportunities for strategic system integration to increase efficiencies in data capture.
- Understand clinical documentation through the lens of local and national quality and ranking methodologies, including U.S. News & World Report, Vizient, Leapfrog, CMS Star Ratings, and payer contracts. Develop and implement strategies to support, educate and engage the team in driving necessary changes.
- The individual will design, lead, and implement monitoring and surveillance of process and outcome metrics and develop, support, and maintain a monthly reporting and communication process with key stakeholders.
- Build and maintain relationships with key stakeholders across various business units, including Hospital Presidents, Senior Leadership Team members, local Quality Directors, Value-Based Care Leadership, Care Coordination/DC management, and Revenue Cycle/Coding/Clinical Documentation Integrity Managers. Engage Physician and Advanced Practice Provider (APP) members to drive quality outcomes for UPMC.
- Responsible for creating and monitoring provider documentation performance and providing feedback and guidance to clinical stakeholders to facilitate improvement.
Qualifications & Experience:
- Bachelor’s degree required; master’s degree in relevant field strongly preferred.
- A minimum of 10 years of progressive healthcare experience, specifically within acute care settings.
- At least 5 years of engagement in healthcare quality and process improvement with a foundational knowledge of key metrics impacting reputation, quality, and financial performance.
- Quality certification in Lean Six Sigma, Certified Professional in Healthcare Quality (CPHQ), or similar credentials in healthcare quality is desired.
- Strong verbal and written communication abilities, with a proven track record of building effective relationships with diverse stakeholders, including clinical staff, management, executive leaders, and external partners.
- Strong analytical skills with at least 3-5 years’ experience utilizing Vizient data (or similar comparative quality analytics platform) preferred.
- Proficiency in Excel, Power BI, PowerPoint, and Vizient CDB.
- Demonstrated leadership experience in performance improvement is preferred.
About Pittsburgh:
Pittsburgh is full of natural beauty – there are 15,000 acres of public parks and green spaces in the city’s urban core and more than 13 state parks in the surrounding region. Pittsburgh has its sights set squarely on a sustainable future – Pittsburgh International Airport is pioneering a new microgrid field with eight acres of solar panels and the airport’s own natural gas. You’ll find world-class architecture in more than 90 unique neighborhoods, each with its distinctive character and charm. Residents here unwind by biking along the region’s 400 miles of trails, wandering through the lush botanic gardens, and basking in the glow of the city’s stunning fall foliage, just to name a few activities. The city is a huge player in the arts, with more than 32 museums, 30 concert venues, and 19 public libraries gifted by steel magnate and philanthropist Andrew Carnegie. Pittsburgh has a robust nonprofit and philanthropy scene, bolstered by generous residents and their donations. Plus, you’ll actually be able to enjoy all that Pittsburgh has to offer, thanks to the city’s low cost of living and doing business. The median price for a single-family home is more than 40% less than the national average.
Source: livability.com, sponsored by the PA Department of Community and Economic Development
Explore the area: visitpittsburgh.com, livability.com/pa/pittsburgh
To further explore this opportunity, express interest, or share referrals, please contact Amy Jones:
Amy Jones, Senior Executive Search Consultant
Morgan Consulting Resources, Inc. ~ Healthcare Executive Search
amy@morganconsulting.com
Additional Responsibilities:
- Partner with department leaders in Revenue Cycle/Coding, Utilization Review/Case Management, and Clinical Analytics to design, develop, and implement targeted initiatives with supportive tools aimed at enhancing quality performance metrics across all entities.
- Develop and implement strategic plans to leverage tools such as Vizient CDB and Epic Bridges, ensuring accurate representations of patient acuity, severity of illness, medical necessity, and risk adjustment.
- In collaboration with the Revenue Cycle/Coding Billing department, design and lead a monthly Clinical Documentation Improvement Committee aimed at creating and sustaining system-level solutions across all UPMC hospitals.
- The position, in partnership with other departments, to advance the standard of quality across UPMC through innovation, learning, and shared deployment of best practices.
- Evaluate, collaborate with, and lead engagements with external vendors that support clinical documentation education, data analysis, and quality.
- Role Responsibilities (alternative options): Develop and execute analytics strategy: Collaborate with Revenue Cycle/coding, Finance, Clinical Analytics, Value Based Care, and Utilization Review/Case Management to establish and implement a comprehensive strategy, defining priorities and a clear roadmap aligned with UPMC quality goals.
- Lead and manage teams: oversee a high-performing team responsible for implement targeted initiatives aimed at enhancing quality performance metrics.
- Monitor trends and influence strategy: Awareness of system performance trends, as well as national healthcare landscape and adjust strategy, analytics and data visualizations and targets to realign system approach to safeguard quality performance.
- Foster collaboration across teams: Act as a strategic partner to internal teams including Revenue Cycle/coding, Finance, Clinical Analytics, Value Based Care, and Utilization Review/Case Management, facility Quality Directors/leadership to ensure alignment and leverage cross-functional expertise to drive success in system and local quality performance.
- Experience presenting to C-suite executives and system leaders desired.
- Proven skills in leadership, strategic planning, and quality improvement initiatives, with the ability to drive organizational change and foster a culture of continuous improvement.
- Project management skills with the ability to facilitate cross-functional collaboration to drive system and local quality performance.
- Experience working with and interpreting clinical and operational data.
- Excellent communication and interpersonal skills.
- Excellent judgment and quality assessment skills, as well as a working knowledge of trends in healthcare management, clinical workflows/practice, and economic factors affecting the healthcare industry.
- Ability to adapt and thrive in a complex organizational environment.
- Willingness to travel as necessary to fulfill job responsibilities.