Planned Parenthood of Southern New England

 

Care. No Matter What.

 

We are Planned Parenthood of Southern New England, one of the region’s largest and most trusted providers of reproductive health care. We are recognized for the wide array of services we provide, the outstanding sexual health education we deliver, and our strong commitment to social justice. Working for Planned Parenthood is more than a job; it’s being a part of a powerful movement. Together, we’ll take pride in shaping the future of sexual health and reproductive rights for all people.  

 

The Director of Clinical Quality Improvement (DCQI) reports directly to the Chief Medical Officer and is responsible for the Clinical Quality Improvement Program (CQI) and the Clinical Risk and Quality Management Program (RQM)as defined in the PPFA Medical Standards and Guidelines.  

 

The CQI Program assures safe and effective clinical outcomes by tracking, trending, and improving clinical quality outcomes on a continuous basis. The Clinical RQM Program includes managing systems and processes to reduce risk and liability and to ensure high quality care in compliance with PPFA, federal, and state regulations. The Clinical RQM program includes active and systemic identification, intervention, and monitoring to support ongoing clinical quality.  

 

The Director of Clinical Quality Improvement is an innovative leader who directs PPSNE’s Clinical Quality Improvement program to ensure exemplary, high quality, data driven patient centered care. The Director of Quality Improvement also works as a member of the Clinical Support Team to maintain a Practice Transformation experience: integrating administrative, financial, and clinical systems for better performance and improved outcomes, with particular attention to the clinical outcomes for patients who identify as Black, Indigenous, and People of Color (BIPOC).   

 

The Director of Clinical Quality Improvement manages the after-hours on-call program. The Director of Clinical Quality Improvement supervises the QI/Lab Nurse Manager and the Manager of Centralized Follow up.  The Director of Clinical Quality Management will have a passionate commitment to PPSNE’s mission and values with a deep sense of accountability to the communities we serve. 

Essential Function

• Champions continuous quality improvement activities across the affiliate by partnering with multiple departments and using data to focus on quality measures, health disparities, and clinical compliance. Implements system and process improvements and engages in PPFA continuous quality improvement special projects. Partners closely with the Director of Clinical Services in these efforts.   
• Responsible for Clinical Quality Improvement Work Plan: Oversees incident reporting process to ensure complete, timely, and accurate reporting. Uses Incident reporting as an opportunity for continuous learning and identifying training needs. 
• Designs, performs, and analyzes annual chart audits for high-risk services as required by PPFA and other clinical audits to ensure accurate EHR documentation in support of excellent patient care. 
• Tracks adverse events and complications for each provider and reviews these regularly with the CMO, program directors, and the RQM committee.  
• Performs root cause analysis and other problem-solving activities to identify effective corrective actions and process improvements. 
• Oversees patient follow-up systems to ensure timely and accurate care. Audits referrals processes and follow up care.  
• Partners with the Director of EHR and the Lead Clinicians to ensure quality documentation and compliance with Medical Standards & Guidelines.   
• Oversees the clinical skills performance review and corrective action process for licensed clinical staff by designing, implementing, and following up on performance review processes.  
• Partners with other PPSNE departments to focus on quality measures, health disparities, and clinical compliance. Implements system and process improvements and engages in PPFA continuous quality improvement special projects. 
• Collaborates with the Clinical Support Team to draft, implement, and maintain policies required for CQI and Clinical RQM Programs to function effectively.  
• Chairs the RQM Clinical Quality Improvement Subcommittee meetings, at least once each quarter.  
• Clinical RQM: Participates in the affiliate-wide Risk and Quality Management program activities, bringing the clinical perspective. 
• Partners with Quality Assurance Manager, QI and Lab Nurse Manager, Health Center Trainers, and center staff to ensure that health centers comply with state and PPFA regulations/requirements. 
• Ensures accurate billing and coding to receive appropriate reimbursement from payers by partnering with Director of Special Projects. 
• Reviews and amends charts for accurate billing. Participates in the annual coding audit/training process.   
• Staff training and education: Partners with Lead Clinicians to provide ongoing training and clinical updates as needed to ensure proactive quality improvement, as well as process improvement in response to audit findings, incident reports, and Press Ganey results through clinician conference calls, clinician conferences, site staff meetings, clinician communication, and direct work with center staff. 
• Provides clinician orientation, proctoring, and ongoing training for new hires and seasoned clinicians in conjunction with the Director of Clinical services and Lead Clinicians.  Ensures documentation of all proctoring, privilege, and training in conjunction with the Health Center Training team.    
• Collaborates with others as necessary to resolve clinical performance-related issues with clinicians including providing written corrective actions.  
• External Responsibilities: Remains up to date on PPFA and ARMS quality program requirements and innovations. 
• Collaborates with ARMS staff and attorneys to prevent and/or resolve legal actions. Engages in service recovery with patients. 
• Coordinates with and for DPH/DOH inspections and corrective actions. 
• Clinical Consultation and Care: Provides clinical consultation (by phone, Teams, or other methods) to manage urgent and ongoing clinical issues including clinical consultation and support.  
• Continues active clinical practice as a licensed clinician, delivering direct patient care  1 day per week, on average.  
• Supervisory: Supports the manager of Centralized Follow Up to grow the department and implement system and process improvements to meet the changing follow up needs of the agency. 
• Supports the QI and Lab Nurse Manager in their functions performing audits and as the Laboratory Technical Consultant. 
• Oversees PPSNE after hours/on call program and manages clinicians who provide clinical consultation and support by phone during evenings and weekends for on-call regions.  
• Work Culture: Works and collaborates with all the members of the Clinical Services Team (CST) to support the services provided at PPSNE. 
• Completes all responsibilities according to established protocols, policies, and standard practices in the areas of customer service, quality assurance and regulatory compliance programs such as HIPAA, OSHA and CLIA.