Coord-Regulatory Qual Programs

Lexington Health, Inc.; Columbia (SC); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Day ONE medical, dental and life ins.

FSAs

403(b) match plan day one

Employer paid life insurance

Long-term disability after 90 days

Student loan forgiveness

Job summary

Lexington Health, Inc. seeks a Quality Management-Ambulatory professional to develop and oversee regulatory quality programs across physician networks. You will manage MU/PQRS/GPRO initiatives, audits, dashboards, and communications with leadership and external vendors.

The role requires healthcare operations knowledge, EHR experience, and strong change-management skills to drive successful program implementation and compliance.

Qualifications

• Experience with regulatory quality programs (MU, PQRS, GPRO, Value Based Purchasing) and audits.
• Understanding of EHR systems and healthcare operations.
• Demonstrated ability to lead cross-functional teams and manage projects.

Responsibilities

• Coordinate development and implementation of physician network regulatory quality programs.
• Prepare reports, dashboards and budgets for assigned areas.
• Lead audits and collaborate with leadership to drive improvements.

Skills

Regulatory knowledge

Leadership

Communication

Project management

Education

Associate's Degree

Bachelor's Degree in Nursing or related field

Job description

Select how often (in days) to receive an alert:

Quality Management-Ambulatory
Full Time
Day Shift
8:30-5:00pm

Lexington Health is a comprehensive network of care that includes six community medical and urgent care centers, nearly 80 physician practices, more than 9,000 health care professionals and Lexington Medical Center, a 607-bedteachinghospital in West Columbia, South Carolina. It was selected by Modern Healthcare as one of the Best Places to Work in Healthcareand was first in the state to achieve Magnet with Distinctionstatus for excellence in nursing care. Consistently ranked as bestin the Columbia Metroarea by U.S. News & World Report, Lexington Healthdelivers more than 4,000babies each year, performs more than 34,000surgeries annually and isthe region's third largest employer.

Lexington Health also includes an accredited Cancer Center of Excellence, the state’s first HeartCARE Center, the largest skilled nursing facility in the Carolinas, and an Alzheimer’s care center.Its postgraduate medical education programs include family medicine and transitional year residencies, as well as an informatics fellowship.

Job Summary

Responsible for the ongoing development, implementation and coordination of physician network regulatory quality programs and initiatives. This includes but is not limited to the continued growth of various programs and projects associated with Meaningful Use (MU), Physician Quality Reporting System (PQRS) GPRO, Value Based Purchasing), regulatory quality program audits, and other regulatory quality programs. The position requires an understanding of health care operations, electronic health records (EHR), quality initiatives, and HITECH programs and regulations. The Coordinator is responsible for communicating and collaborating with physician network leadership, management, internal customers and external vendors to facilitate and ensure successful implementation and completion of projects related to physician network regulatory quality and government initiatives. Responsible for overseeing timelines, project and program management and compliance, reporting and resources for all aspects of the regulatory quality and government programs and initiatives. Requires outstanding leadership, communication, project management and change management skills to influence and guide team members, providers, other physician network areas, physician practice leadership and organizational leadership throughout all aspects of the regulatory quality and government programs. Performs as the physician network subject matter expert for all regulatory quality programs and initiatives and informs leadership team and stakeholders of regulatory changes in a timely fashion as program guidelines are modified by various regulatory agencies.

Minimum Qualifications

Minimum Education: Associate's Degree
Minimum Years of Experience: 6 Years of experience;
3 Years of related experience working directly with EHR systems.
Substitutable Education & Experience: Associate's Degree with 6 Years of experience can be substituted for the following:
Certification in area of clinical practice such as Certified Meaningful Use Professional and/or Certified PQRS Professional and 6 years of experience;
Bachelors of Science degree in Nursing or other related clinical field and 4 years of experience in healthcare environment;
Master’s Degree in clinical field or other related field and 2 years of experience in healthcare environment (i.e. Pharmacist, RN or Midlevel practitioner).
Required Certifications/Licensure: None.
Required Training: Demonstrated experience with progressive project management and change management.

Essential Functions

• Responsibility for the coordination and delivery of physician network regulatory quality programs and initiatives. This includes but is not limited to the continued growth and management of various programs and projects associated with Meaningful Use (MU), Physician Quality Reporting System (PQRS) GPRO, Value Based Purchasing), regulatory quality program audits, and other regulatory quality programs.
• Prepares activity, performance, progress reports and budget recommendations for assigned areas on a regular basis.
• Maintains up to date reports and dashboard data for physician network leadership, physicians and other stakeholders within the practices.
• Leads vendor issue management and escalations related to physician network regulatory quality programs and initiatives.
• Responsible for the escalation and collaboration with the Director of Population Health and Clinical Integration regarding issues and risks to identify solutions.
• Responsible for the coordination of communication and project status updates for assigned areas.
• Collaborate with the physician network Director of Training Systems, Education and Development with the implementation of training programs to align work flow and organizational “culture” with the physician network regulatory quality initiatives.
• Oversee the ongoing development and upgrading of policies and procedures necessary for assigned areas.
• Participate, facilitate and/ or lead projects with other leadership and teams to plan, implement and/or optimize clinical systems that support compliance with regulatory quality initiatives.
• Develops efficient process for various regulatory program audits such as but not limited to Meaningful Use of Electronic Health Records, PQRS (GPRO), etc.

Duties & Responsibilities

• Prepares for regulatory audits by conducting internal mock audits for various regulatory quality programs.
• Responds within specified timeframes for regulatory audit requests and communicates with regulatory agencies throughout the audit process.
• Communicates to LMC physician network leaders and stakeholders related to regulatory audit findings and opportunities for ongoing improvement.
• Works with multiple organization stakeholders, using critical thinking to triage issues and continuously evaluate methods to improve all regulatory quality programs and initiatives.
• Demonstrate leadership, collaboration, critical thinking, and teamwork in addressing decisions and resolving issues.
• Collaborate with multidisciplinary teams in the areas of clinical, administrative, and finance.
• Serves as a champion and change manager for all assigned areas of responsibility.
• Serve as the Subject Matter Expert for all aspects of the regulatory quality initiatives within assigned areas.
• Maintains an ongoing working knowledge of all applicable federal regulations and standards to ensure compliance.
• Performs all other duties as assi

We are committed to offering quality, cost-effective benefits choices for our benefit eligible employees and their families:

• Day ONE medical, dental and life insurance benefits
• Health care and dependent care flexible spending accounts (FSAs)
• Employees are eligible for enrollment into the 403(b) match plan day one. LHI matches dollar for dollar up to 6%.
• Employer paid life insurance – equal to 1x salary
• Employee may elect supplemental life insurance with low cost premiums up to 3x salary
• Adoption assistance
• LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
• Student loan forgiveness

Equal Opportunity Employer
It is the policy of Lexington Health to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. Lexington Health strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. Lexington Health endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee’s desires and abilities and the hospital’s needs.