Clinical Performance Advisor - RN

TSG Resources, Inc.; Kansas City (MO); On-site; USD 110,000 - 170,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Match

Paid Time Off

Holidays

Professional Development

Job summary

SCP Health in Kansas City, MO is seeking a senior health quality leader to oversee clinical performance improvement and patient care coordination across hospital and facility programs.

You will lead QA/PI activities, partner with Medical Directors and field teams, drive data‑driven improvement, and ensure compliance with Medicare/Medicaid standards while supporting organizational goals.

RN required with 5+ years as a clinician; Master’s preferred; strong communication and collaboration skills.

Qualifications

• Knowledge of Medicare, Medicaid, and Marketplace lines of business.
• Knowledge of relevant state and federal healthcare regulations.
• Intermediate knowledge of healthcare informatics and quality measures.
• Staff development and education process knowledge and quality improvement methodology.
• Ability to plan, coordinate QA and PI activities.
• Understanding of budgeting processes and principles.

Responsibilities

• Represent SCP Health to retain referrals and grow volumes through patient, provider, and facility engagement.
• Coordinate training and orientation for new staff and providers; ensure access and training.
• Lead liaison work with Medical Directors and hospital staff to recruit providers and coordinate tours.
• Promote communication across hospitalist teams, patients, families, and SCP Health staff.
• Monitor performance and propose improvements to KPI, quality, and satisfaction metrics.
• Participate in standing committee meetings and support value-based care initiatives.

Skills

Medicare rules

Healthcare regulations

Healthcare informatics

QA/PI planning

Budgeting

Partnership building

Communication skills

Matrix organization

MS Office

Education

Bachelor's in Nursing

Master's preferred

Tools

MS Office

Job description

At SCP Health, what you do matters As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.

Why you will love working here:

• Strong track record of providing excellent work/life balance.
• Comprehensive benefits package and competitive compensation.
• Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.

RESPONSIBILIITES:

Represent SCP Health, patient services, and the Hospital to ensure retention of existing referral sources, grow new referrals and volumes by enhancing client, PCP, Patient and Provider Satisfaction, as well as Quality Case Management, Emergency Department, and other facility relations. Support training coordination and orientation process of new office staff, and all patient care providers including, but not limited to, maintaining current orientation packets, obtaining computer access and any facility specific training. Participate in physician interviews and coordinate with the Staffing Operations team to ensure applicants meet with the medical directors and tour all facilities of interest. Act as a professional representative in dealing with all levels of hospital and staff personnel and promote communication within the hospitalist team and with hospital staff, patients/families, caregivers, administration, nursing staff, referral sources, care management, and SCP Health corporate team members. Serve in support of the Medical Director as point person and liaison for the program. Ensure accomplishment of organizational and program goals by maintaining and cultivating collaborative relationships with key personnel. Monitor onsite performance, operational challenges, and share recommended strategies for improvement and efficiencies to the VP of Clinical Performance Improvement and the Field Operations teams. Oversee daily practice operations and support the needs of the program related to physician engagement, facility initiatives and priorities. Lead and support daily workflows designed to drive clinical performance initiatives. These include, but not limited to, daily throughput/LOS workflows, MDR attendance, physician/patient rounding, provider education, data analysis and service recovery. Recommend and implement improvements to the practice as it relates to KPI’s, and Client & Provider Satisfaction as established by both the SCP Health and client teams. In collaboration with the SCP Field Operations team, Medical Director, establish and facilitate standing HM Committee meetings between Hospital Administration, designated facility department managers, and SCP Health HM representatives (include ED representatives if contract includes both). Facilitate engagement with Medical Director(s) to result in meeting participation, provider recruiting and retention. Availability by phone or pager for emergencies, patient complaints, high-risk patients or situations and all practice support functions. Work with hospital administration to attain the group’s key clinical and practice indicators relating to quality, core measures, readmission rates, length of stay, case mix index (CMI), billing/diagnostic coding trends, and daily volume statistics. Participate in organizational planning and evaluation of the program in conjunction with Medical Director and Field Operations team with collaborative communication, constructive feedback, problem solving, data analysis, operational reviews. Meet regularly and assist Medical Director and Field Operations team in development of clinical protocols, order sets, workflows, best practices, engagement, etc. Ensure completion of all site-specific requirements. Participate in required corporate meetings, training sessions, organizational pilot programs, and cross coverage as requested. Support value-based care goals and data/information sharing requirements. Additional duties and responsibilities as requested by VP of Clinical Performance Improvement and Field Operations team.

QUALIFICATIONS: Knowledge, Skills, and Abilities:

• Knowledge of Medicare, Medicaid, and Marketplace lines of business and applicable regulatory requirements.
• Knowledge of relevant state and federal healthcare regulations.
• Intermediate knowledge of healthcare informatics, including clinical quality measures.
• Working knowledge of staff development and the educational process, quality improvement, continuous process/performance improvement methodology, preferred.
• Demonstrated ability to plan, coordinate, and evaluate Quality Assurance (QA) and Performance Improvement (PI) activities, preferred.
• Understanding of financial and budgeting processes and principles.
• Ability to build effective partnerships within the organization to collaboratively execute business strategies.
• Effective oral and written communication skills.
• Ability to work effectively in a matrixed organization.
• Intermediate Microsoft Office proficiency (i.e., Outlook, Excel, and PowerPoint).

EDUCATION:

Bachelor’s degree in nursing, or healthcare relevant field required. Master’s degree, preferred.

WORK EXPERIENCE/QUALIFICATIONS:

• 5+ years’ experience as a clinician in an acute healthcare setting.
• 3+ years of clinical quality assurance, data analytics and reporting experience in a managed-care setting.
• Prior case management experience.
• Direct patient care experience, ICU/EM experience, preferred.
• Experience with hospital‑based and outpatient clinical quality measures, strategies, and reporting.

CERTIFICATIONS:

RN, required.

PRIMARY LOCATION:

Research Medical Center - Kansas City, MO

Pay Range:

This range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations.

• We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources.