INTEGRIS Health

Key Responsibilities

• • Lead the development and execution of a unified quality and performance improvement strategy that aligns medical group initiatives with the health system’s quality goals, population health priorities, and value-based reimbursement contracts (e.g., ACOs, Medicare Advantage, commercial VBCs).
• • Collaborate closely with health system leadership, including the Chief Physician Executive, PHSO leadership, population health teams, and finance to ensure alignment and integration of clinical quality initiatives and data analytics.
• • Serve as a clinical quality liaison between the medical group and the health system to promote standardization of care protocols, best practices, and quality metrics reporting.
• • Drive improvements in clinical quality measures, patient safety, care coordination, and patient experience across multiple specialties within the medical group.
• • Oversee quality reporting and improvement activities related to VBC contracts, including HEDIS, STAR ratings, MIPS/MACRA, and health plan pay-for-performance programs.
• • Participate in root cause analyses, clinical audits, and risk mitigation efforts to reduce variation, prevent adverse events, and enhance care delivery efficiency.
• • Partner with health system analytics and IT departments to develop real-time dashboards and reports that track performance against quality and financial targets.
• • Use data to identify care gaps, optimize risk adjustment coding, and inform clinical decision-making to maximize contract performance and patient outcomes.
• • Ensure timely submission of required quality and compliance data to payers, regulatory bodies, and accreditation organizations.
• • Oversee compliance with all applicable federal, state, and payer regulations and standards.
• • Support preparation for and response to external audits, accreditation reviews (e.g., Joint Commission, NCQA), and contractual performance assessments.
• • Maintain up-to-date knowledge of evolving healthcare quality and reimbursement policies to guide the medical group’s response to regulatory changes.
• • Build and mentor a multidisciplinary quality team within the medical group and foster strong partnerships with physicians, nurse leaders, care managers, and administrative staff.
• • Promote a culture of continuous quality improvement, patient safety, and accountability aligned with the health system’s mission and values.
• • Facilitate training and professional development programs focused on quality improvement methodologies, VBC education, and clinical documentation excellence.