Medical Director - Quality Transformation

Date: Jan 1, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 6224 

 

Position Summary/Position

 

At Inland Empire Health Plan (IEHP), we believe the highest quality of care should be delivered to all in the Inland Empire.  We are thinking beyond the way Quality is viewed today – we believe it should be holistic and transformative.  


Reporting to the Vice President of Quality, the Medical Director of Quality Transformation is responsible for advancing our current approach to Quality by leveraging sustainable innovation, new tools and partnerships, and new business models all in service to improving our quality ratings, healthcare delivery, data & analytics, and experience. The Medical Director – Quality Transformation will:  lead the design, development and execution of initiatives and programs; help develop strategy so that quality-based activities are both present forward and future back in line with IEHP’s strategic plan; define and manage new quality-based initiatives and liaison with internal and external stakeholders; enhance provider workflows to improve quality at the PCP, IPA and Hospital level. The Medical Director of Quality Transformation will also participate cross-functionally in business planning efforts to support IEHP’s Mission, Vision and Values and will be responsible for navigating quality regulatory requirements in the Medi-Cal space.

Major Functions (Duties and Responsibilities)

 

  1. Influence change management within a large organization.
  2. Develop strategic alignment between payment models and transformative initiatives rooted in quality.
  3. Implement initiatives that account for provider workflows resulting in improvement in quality.
  4. Facilitate design thinking workshops with different internal business units and stakeholders.
  5. Liaison with external vendor partners to successfully align and scope work that align IEHP’s strategic plan.
  6. Make enterprise recommendations to achieve a health plan 5-star rating.
  7. Connect strategic initiatives to incentive pay for performance programs, including evaluation and monitoring of relevant quality metrics.
  8. Prioritize, rationalize, and modernize current quality improvement initiatives.
  9. Drive improved quality outcomes at the provider level.
  10. Other duties as assigned.

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications

 

Minimum of twelve (12) years of experience in a relevant healthcare related setting. Experience in care coordination and care/disease management in an ACO or FQHC environment. Strong product and program management experience, product delivery, product environments, and management consulting.

Preferred Experience

Education Qualifications

 

Minimum of a Medical Degree in a clinically related field (e.g., MD, DO) from an accredited institution required.

Preferred Education

 

Additional Master’s Degree (e.g., MS, MPH, MBA) from an accredited institution preferred.

Professional Certification

Professional Licenses

Possession of an active, unrestricted, and unencumbered Physician’s and Surgeon’s Certificate issued by the State of California Medical Board preferred.

Drivers License Required

Yes, must have a valid California Driver's license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points.

Knowledge Requirement

 

Strong understanding of clinical regulatory environments, including DHCS, NCQA and CMS. Strong understanding of current trends in health care and clinical operations.

Skills Requirement

Excellent Word, Excel, and PowerPoint skills. Superb communication skills, including oral and written presentation. Familiarity with Tableau or Power BI.

Abilities Requirement

Communicate difficult concepts in a concise, elegant, and effective ways to key stakeholders, including providers, to reach consensus. Team player with an ability to build trust with internal and external stakeholders.

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

Physical Requirements

Keyboarding: Traditional - FREQUENTLY
Hearing: One-on-One - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Lighting - CONSTANTLY
Regular contacts: co-workers, supervisor - FREQUENTLY
Regular and reliable attendance - CONSTANTLY
Keyboarding: Touch-Screen - FREQUENTLY
Sitting - CONSTANTLY
Indoors - FREQUENTLY
Keyboarding: 10-Key - FREQUENTLY
Communicate: Verbally engage with customer base - FREQUENTLY
Perform complex and varied tasks - CONSTANTLY
Develop and maintain positive work relationships - CONSTANTLY
Regular contacts: recurring clients - FREQUENTLY
Other contacts: public exchange - FREQUENTLY
Other contacts:one-time clients - FREQUENTLY
Decision-making - CONSTANTLY
Lead/Influence Others - CONSTANTLY
Work review - FREQUENTLY
Rapid Pace of work - FREQUENTLY
Control of work pace - FREQUENTLY
Problem Solving - CONSTANTLY
Memory - CONSTANTLY
Understand and follow direction - CONSTANTLY

 

Starting Salary: $227,052.80  - $312,187.20  

Pay rate will commensurate with experience

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 2,000 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles