Director, System Clinical Quality Performance

Purpose:
UPMC is seeking a Director of System Clinical Quality Performance to oversee quality functions at the system level within our healthcare organization. The successful candidate will establish strategic initiatives, develop quality priorities, align quality analytics, and facilitate collaboration across our network of hospitals.A key responsibility of this role is to evaluate, design, lead, and implement a coordinated approach to clinical quality performance and processes and documentation best practice across UPMC. The ideal candidate is a proactive leader who can effectively drive change, foster collaboration, and ensure continuous improvement of quality outcomes throughout our healthcare system.

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.
• 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.
• 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.
• Oversee and analyze internal and external performance benchmarks to identify areas of improvement. Identifies opportunities for strategic system integration to increase efficiencies to increase efficiencies in data capture.
• 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.
• Possess and apply foundational knowledge of quality documentation best practices. The candidate will be responsible for creating and monitoring provider documentation performance and providing feedback and guidance to clinical stakeholders to facilitate improvement.
• 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.
• 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 partnerships with other departments to advance the standard of quality across UPMC through innovation, learning, and shared deployment of best practices.
• 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.
• Evaluates, collaborates with, and leads 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.