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Req# 28597 Aultman Health Foundation, CANTON, OH AULTCARE ADMINISTRATION Aultman Health Foundation Full Time, Day Shift, 8a to 5pm PURPOSE OF POSITION: The Director of Clinical Quality, Disease Management and Case Management reports to the Vice President of Quality and works closely within the Quality team and in collaboration with other operational and clinical teams in order to administer the organizations Quality program and workplan in order to meet all quality of care and quality of service goals of the organization. The primary purpose of the Director Clinical Quality, Disease Management and Case Management is to provide strategic recommendations, design and execution of those strategies and initiatives to drive quality and culture in order to consistently achieve star rating and quality performance goals. This position includes the ability to utilize population health platforms, analytic tools and various sources of data to identify opportunities in care gaps and quality performance. The Director Clinical Quality, Disease Management and Case Management will be responsible for execution of the organizational strategies related to the Quality program, disease management program and case management program. This role leads the strategy and direction to improve member and provider quality engagement. The Director Clinical Quality, Disease Management and Case Management will lead, oversee and mentor the clinical supervisors to develop and drive quality subject matter expertise and technical skills development. RESPONSIBILITIES & EXPECTATIONS: Participates in strategic project initiatives, including the design, development, testing, implementation, and ongoing support across quality projects Directs the development and advancement of skillsets and business subject matter expertise of the Quality team members Works directly and collaboratively with Senior management to develop strategic quality initiatives. Contributes to monthly staff meetings, ensuring appropriate information is reported and communicated. Maintains mutually beneficial relations with physicians Assists leaders in department indicators and compliance activities Prepares presentation reports with action plans and evaluations. Ensures staff compliance with policies and procedures Develops and maintains knowledge of key performance indicators related to Quality including but not limited to CMS Stars, HEDIS, compliance with regulatory agencies, etc. Supervises the development and progress of investigative analytics and ad hoc requests as it relates to quality of care and service Effectively visualizes and communicates the risks, insights, patterns, and trends from reports and sources, and provides recommendations Collaborates directly with internal and external business units to identify opportunities to enhance program outcomes Identifies, leads, tracks, develops action plans and monitors for continuous improvement related to quality and star initiatives, work plan and performance dashboards. Develops, implements, and executes strategies to improve member experience and quality outcomes by engaging and educating internal stakeholders, vendors, partners, and providers Identifies and implements opportunities to streamline and improve processes. Builds a first-in-class clinical quality, case and disease management program using creative, innovative strategies and best practices. Provides training, orientation, performance appraisals of supervisory staff; Ensures team develops new data competencies. Process Improvement: Continuously reviews, recommends and implements improvement steps, as needed or directed Oversees the quality clinical team in quality programs Portrays professional image: follows dress code; communicates with internal and external customers in a professional manner, including appropriate verbal and written gramm