Manager of Provider Quality

Mercyhealth Wisconsin and Illinois

Janesville (WI)

On-site

USD 82,000 - 132,000

Full time

7 days ago

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Benefits offered by this job

Medical, Dental, Vision

Life & Disability Insurance

FSA/HSA Options

Paid time off

Parental and caregiver leave

Tuition and certification reimburse-

Well-being Programs

Employee Discounts

On-Demand Pay

Job summary

Mercyhealth in Wisconsin and Illinois seeks a leader to manage peer review processes, analyze clinical performance data, and drive quality initiatives across the organization. You will collaborate with medical staff and system leaders, oversee data-driven performance improvement, and guide a team in standardizing reporting and compliance.

The role includes education of physicians, coordination of reviews, and participation in accreditation readiness and budget adherence.

Qualifications

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.
Previous managerial or supervisory experience with progressively increasing responsibility required.
Quality data measurement, report analysis and data interpretation experience preferred.

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 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 and related evaluations.

Skills

Interpersonal skills

Communication skills

Excel

Access

Independent judgment

Education

Bachelor’s degree in healthcare field

5 years healthcare experience

Medical terminology course

Tools

Microsoft Excel

Microsoft 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.
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 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 supervises 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

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.

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

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: