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VP, Quality & Risk Management

Company: MemorialCare Health System
Location: Fountain Valley
Posted on: May 27, 2019

Job Description:

Job Summary:
Responsible for the organization and delivery of a comprehensive framework for performance improvement of quality, safety and risk management across MemorialCare.

This position reports to the incumbent health system Chief Transformation Officer, with a matrix to health system Chief Investment Officer and CFO for claims and insurance administration.

Duties and Responsibilities:



Strategic
Develop, organize, implement and administer our strategic focus on improving system-wide performance for patient-facing quality and safety across the system as well as minimizing the financial severity of claims loss. This position has the responsibility to:




  • Serve as an internal and external listening post and advocate for the organization to then integrate ideas to foster our Bold Goals to improve performance, developing tactics to solve issues and overseeing successful implementation and measurement.

  • Partner with physicians, leaders and staff to execute on specific strategies for improvement.

  • Provide organizational expertise and resource for clinical and administrative regulations and accreditation requirements.

  • Administer and provide oversight to insurance products (HPL. GL, Cyber, other) and as well management of self -insurance programs.

  • Implement claim management strategies for effective resolution including establishment of appropriate reserves for HPL claims and collaboration with our physicians as partners.

    Operations:


    • Oversee and facilitate key committees for review and action, including the Physician Society Board, MHS Quality Committee, MHS Quality Close and supportive Value-Added Teams (VATs) and Best Practice Teams (BPTs)
    • Oversee the activities of shared service functions involved in supporting clinical data, best practice and MCSS Lean Advance Team
    • Network with entity leaders to improve local performance and synthesize for system-wide sharing and improvement
    • Oversee the clinical risk management and loss prevention programs associated with these strategies including implementation of effective patient safety /risk mitigation actions
    • Provide oversight for system-wide policy and procedure development, integration and management system
      Qualifications and Requirements:


      • Minimum 5 years executive experience in healthcare improvement with demonstrated system-level capabilities in overseeing progressive programs for quality, safety, clinical risk, claims and insurance management.
      • Knowledge: Demonstrated expert knowledge in performance improvement, quality, safety, risk and insurance.
      • Special Skills: Strong and reliable negotiation skills; critical thinking and analytical capabilities; political skills to enhance relationships; people skills to enhance employee relationships and maximize leadership strengths; public relation skills; executive presence.
      • Expert at Microsoft Excel, Word and PowerPoint.

        Education:


        • Clinically focused advanced credential such a Masters in Nursing, Doctor of Pharmacy or other advanced degree. Certifications in risk management and in performance improvement highly desired.

Keywords: MemorialCare Health System, Los Angeles , VP, Quality & Risk Management, Executive , Fountain Valley, California

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