Medical Director, Quality & Clinical Performance

Company: CEDARS-SINAI
Location: Beverly Hills
Posted on: March 12, 2023

Job Description:

Cedars-Sinai is seeking a Medical Director for Quality and Clinical Performance. The Medical Director for Quality and Clinical Performance works closely under the Chief Medical Officer and with the Director, Quality and Performance Improvement to promote the highest quality of care and to enhance the culture of safety in the Cedars-Sinai Medical Network. Incumbent is a key member of the Population Health team and will serve as the representative for all quality initiatives that relate to working in an ambulatory environment. The incumbent will be a quality thought leader and influencer of physicians and other Medical Network staff. Working in a dyad relationship with the Director, Quality and Performance Improvement, the incumbent creates strategies and oversees processes to ensure reliable performance around preventive and chronic care outcome measures for all accountable populations and programs, and strategizes and works with other leaders to advance appropriateness of care initiatives throughout the Medical Network. This involves collaborating closely with key physician leaders, primary and specialty providers, and operational leadership to prioritize efforts, implement new initiatives and communicate updates and changes relevant to the quality program. Incumbent develops strong relationships with other stakeholders including hospital quality leadership, quality leaders at other Cedars-Sinai Health System sites, and health plan quality teams. Incumbent has a strong analytic background and works with analytic and informatics partners to track and trend performance, create feedback mechanisms to physicians and operational teams, and optimize electronic environments to support quality efforts. Incumbent regularly uses data to understand problems and to identify tactics for improvement. Incumbent evaluates, and provides feedback on health plan proposals related to quality metrics and pay for performance incentive programs, continuously evaluates and prioritizes our response to these programs, and works with internal and external teams to drive success.

Working in a dyad relationship with the Director, Quality and Performance Improvement, and the Director, Risk Management, the incumbent oversees the Voice of the Customer program, providing clinical input to patient complaints and grievances, analyzing trends, and working with operational teams to streamline service recovery and enhance the patient experience. Incumbent facilitates processes to support provider teams and represent patients when managing difficult interactions. Incumbent is also a key leader in ambulatory safety, providing guidance and support to the Quality team in efforts to promote a Culture of Safety, including promoting incident reporting, transparent communication and a no-blame approach to errors. This may involve leading and participating in root cause analysis, working closely with physicians and operations to ensure the safety of in-office care, and working with the Director, Clinical Operations, to establish appropriate policies and procedures to ensure patient and staff/physician safety in clinical environments. Incumbent works closely with the Chief Medical Officer on processes related to Credentialing and Peer Review. The Medical Network (MN) is home to over 1,400 physicians who each practice in one of 15 highly rated medical groups, including Cedars-Sinai Medical Group and Cedars-Sinai Health Associates. Each of the groups has a professional services agreement with the Cedars-Sinai Medical Care Foundation (CSMCF). The Medical Network also includes medical group support functions including physician billing services and a management services organization (MSO). First established in 1994, the MN is rapidly growing as additional, highly prestigious groups have joined the organization. The MN is now broadly geographically dispersed, with primary care and specialty medical and surgical groups in Los Angeles County and some sites in Orange County. Total revenue of the MN is $530 million, and related ambulatory surgical and diagnostic centers revenue is more than $100 million. The MN serves as the principal population health-based physician contracting entity for the Cedars-Sinai Health System (CSHS). In this role, as well as through specialty care related initiatives, it serves as an important site of innovation and development with regard to quality, clinical efficiency and performance improvement under value-based contracts that CSHS pursues. It is also a key strategic venue for the development of patient engagement initiatives and the deployment of information technology in support of quality, safety and efficiency in the ambulatory setting. The Cedars-Sinai Medical Group and Cedars-Sinai Health Associates are among the best performing medical groups in California. At Cedars-Sinai Medical Center we are proud of our diverse team and inclusive work environment. We are committed to recruiting, selecting and retaining an engaged workforce from many backgrounds, perspectives and experiences at all levels of the organization, including age, gender identity, race, religion, gender, sexual orientation, physical or mental disability, military and/or veteran status or any other basis protected by federal and state law.
Educational Requirements:MD or DO required with completion of residency and board-eligibility in a medical specialty (board certification preferred).

License/Certifications:Current valid license to practice medicine in the State of California required.Board certification or board eligibility in one of the ABMS specialties required.

Experience:

• Five (5) years minimum of progressive and successful physician leadership required; ten (10) years of prior work experience in a health care setting highly desired.
• 2 or more years' experience in appeals and grievances review, case review, and/or quality improvement activities in a managed care setting, or equivalent, is preferred.
• 2 or more years HMO/Managed Care experience is preferred.
• 2 or or more years experience in NCQA/HEDIS, Medicare Star Ratings, Quality Improvement required. Interested applicants should submit: 1. A curriculum vitae; 2. Cover letter; 3. A diversity & inclusion statement describing your past contributions to diversity, equity, and inclusion and your future plans for continuing these efforts (two pages or less). Please submit to:
  Working Title: Medical Director, Quality & Clinical Performance
  Department: MNS Quality Mgt
  Business Entity: Medical Network
  Job Category: Academic/Research
  Job Specialty: Faculty
  Position Type: Full-time
  Shift Length: 8 hour shift
  Shift Type: Day
  Base Pay:$293,913.00 - $394,502.00
  

Keywords: CEDARS-SINAI, Beverly Hills , Medical Director, Quality & Clinical Performance, Healthcare , Beverly Hills, California