Manager of Provider Quality

Mercy Health System; Janesville (WI); On-site; USD 82,000 - 132,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

Paid time off

Tuition and certification reimburse

Job summary

Mercyhealth in Wisconsin is seeking an experienced leader to oversee peer review processes, analyze physician performance data, and drive organization-wide quality initiatives. You will collaborate with medical staff and system leaders to strengthen regulatory readiness and guide a team in delivering meaningful improvements across Mercyhealth.

The role emphasizes education of physicians, standardization of reporting across facilities, and partnership with risk management and administrative

Qualifications

• Bachelor’s degree in a healthcare field or equivalent.
• Completion of a medical terminology class is required.
• Master’s degree preferred.
• CPHQ certification within 1 year required.
• Proficient in Microsoft Excel; Access experience preferred.

Responsibilities

• Manage peer review and data reporting for the medical staff across the organization.
• Educate physicians and leaders about the Peer Review process and quality measures.
• Coordinate standardized physician reporting across the organization and facilities.
• Attend medical staff meetings and provide reports and feedback as requested.
• Oversee data used for physician performance improvement and evaluations.

Skills

Leadership

Quality improvement

Data analysis

Excel advanced

Communication skills

Education

Bachelor’s degree in healthcare field

Master’s degree preferred

Tools

Excel

Access

Job description

Overview

Are you passionate about healthcare quality, physician performance, and continuous improvement? Join our team and play a vital role in advancing patient care by leading peer review processes, analyzing clinical performance data, supporting physician development, and driving organization-wide quality initiatives. In this impactful leadership role, you’ll collaborate with medical staff and system leaders, strengthen regulatory compliance and accreditation readiness, and guide a dedicated team in delivering meaningful improvements across our organization. Shift: Monday to Friday Day Shift Hours Schedule: 40 hours per week

Essential Duties and Responsibilities

Manages peer review and data reporting functions of the medical staff, using clinical triggers and occurrence reporting for case finding
Educates and coaches new physicians and physician leaders about the Peer Review process and quality measures.
Works with members of the medical staff and system leaders to ensure timely reviews and provides information as needed
Attends medical staff department meetings as the Quality and Peer Review representative; provides reports and feedback as requested.
Manages physician reporting activities and coordinates work to ensure standardization across the organization
Analyzes performance, identifies trends and makes recommendations to the Medical Staff for new measures.
Educates Leaders and Medical Staff on new measures, requirements and impact on the organization
Provides oversight of reports and data used for physician performance improvement, ongoing professional practice evaluation and focused practice evaluation
Collaborates with medical staff leadership, risk management and administrative leaders to makes recommendations for further investigation or improvement
Participates in committees related to performance initiatives of the Medical Staff
Ensures coordination of measures and indicators and standardization of process between facilities
Collaborates with multiple departments to ensure data validity, reliability, accuracy and timeliness.
Assists with accreditation preparation and compliance monitoring related to quality, performance improvement and medical staff standards.
Participates in planning and project management as requested.
Provides direct managerial oversight to identified partners, including Data Specialist staff.
Leads annual evaluation and quarterly coaching meetings.
Assists in the preparation of and adherence to the department budget.

Culture of Excellence

Behavior Expectations To perform the job successfully, an individual should demonstrate the following behavior expectations:

• Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.
• Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.
• Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.
• Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.

Education and Experience

Bachelor’s degree in a healthcare related field required or Bachelor’s degree with 5 years’ experience in a healthcare field and completion of a medical terminology class required. Master’s degree preferred. Previous managerial or supervisory experience with progressively increasing responsibility required. Quality background required including previous experience with data measurement, report analysis and data interpretation is preferred. Advanced level of experience using Microsoft Excel is required. This includes the ability to create and maintain spreadsheets, manage the graphical display of data, utilize advanced functions and formulas. Moderate level of Microsoft Access experience is preferred. This includes database creation, table maintenance and related problem-solving.

Certification and Licensure

CPHQ certification within 1 year required.

Skills and Abilities

Excellent interpersonal and communication skills. Ability to define problems, interpret data, establish facts and draw valid conclusions. Ability to work with partners in achievement of strategic goals. Position requires a high level of independent judgment and has latitude for independent action.

Special Physical Demands

The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations. While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel. Employee is required talk and hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand; walk; sit and climb or balance. The employee must regularly lift and /or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and distance vision.

Level of Supervision Responsibilities

Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems; employee adherence to annual education and certification requirements Supervises Directly supervisor Data Specialist 1, 2 and 3. Supervisory responsibilities are conducted in accordance with directives of management, the organization's policies, and applicable laws.

PAY RANGE

$82,330.93 - $131,729.48

Equal Opportunity Employer

Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.

Benefits Package

Mercyhealth offers competitive pay and a comprehensive benefits package including:

• Medical, Dental, Vision Life & Disability Insurance FSA/HSA Options Generous, accruing paid time off Paid Parental and caregiver leave Career advancement and educational opportunities Tuition and certification reimbursement Certification Reimbursement Well-being Programs Employee Discounts On-Demand Pay Financial Education Annual recognition/awards events Partner appreciation days Family entertainment/attractions discount Community service/improvement opportunities

Company Culture

At Mercyhealth, we don’t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin. Mercyhealth has been nationally recognized for our commitment to our people and culture, including: #1 in the nation on AARP's Best Employers for Workers Over 50 One of Working Mother magazine's 100 Best Companies for Working Mothers A Top 50 Company and Top 10 Nonprofit for Executive Women For over 135 years, Mercyhealth has provided high-quality health care to residents throughout northern Illinois and southern Wisconsin. We have a passion for providing comprehensive health care close to home for area residents through our six hospitals and 85 primary and specialty care locations. As an integrated health system, you can come to us for routine health care, like annual physicals, immunizations and preventive health screenings, as well as highly specialized care, such as neonatal intensive care, heart surgery, stroke care, neurosurgery, cancer treatment and much more. The range of Mercyhealth's specialties and the skills of our doctors, nurses and clinical staff are truly extraordinary.