Director, Ambulatory CDQI - Mount Sinai Health Partners

Job Description

 The Mount Sinai Health System

Director for Ambulatory CDQI



Mount Sinai is one of the leading US health systems and a top-ranked academic medical center. We are transforming our business to focus on population health – our goal is to keep entire communities healthy and out of the hospital. Mount Sinai Health Partners (MSHP) is the team driving this transformation within Mount Sinai. The team includes 350+ employees with clinical, contracting, finance, IT, analytics, and operations expertise.


We are accelerating a transition to a business model focused on population health management – our goal is to keep entire communities healthy and out of the hospital.  Mount Sinai Health Partners (MSHP) is the team driving this transformation within Mount Sinai.  The team includes 400+ employees with clinical, contracting, finance, IT, analytics, operations, and product development expertise. 


MSHP is a fast growing business unit within Mount Sinai and is looking for team members who:


·         Are comfortable “playing up” and “playing down” as needed to accomplish business objectives

·         Work productively amidst ambiguity

·         Thrive in fast-paced  work environments

·         Seek to improve the status quo 


The Clinical Operations Team within MSHP drives the implementation and ongoing improvement of clinical initiatives that enable Mount Sinai to deliver better value to its patients, its providers, its customers (i.e., plan sponsors and payers), and its partners. At Mount Sinai, value is defined broadly and encompasses improved health outcomes, more efficient operations, better patient experience, more joyful care team environment, and improved financial performance. The Clinical Operations team works directly with the Chief Population Health Officer and Chief Clinical Integration Officer of Mount Sinai.  


Mount Sinai is embracing new payment models that reward value-based arrangements to foster ongoing health improvement.


The Ambulatory CDQI team is responsible for identifying opportunities for more thorough, specific, and appropriate clinical documentation to better characterize and understand the health needs and risks of our patient population as a means to promote the delivery and coordination of high-quality care. The program is essential for ensuring that we meet critical contract thresholds and that our patients have an effective and seamlessly connected healthcare experience.


Role Summary


MSHP seeks a Director for Ambulatory CDQI to develop program strategy; serve as the lead HCC subject matter expert, manage daily team operations; drive performance and ongoing improvement through leadership; identify and track key performance indicators, including financial ROI of the program; align with the well-established inpatient CDQI program where appropriate; and ensure consistency in clinical documentation, coding, and physician education.. This role is both strategic and operational, with responsibility for maintaining and improving the CDQI department that serves both employed and voluntary physicians. The Director will interact with a wide variety of stakeholders throughout the health system and will be responsible for building and managing a growing team of Clinical Documentation Specialists.


·         Develop and implement policies and procedures, standard operating procedures, and workflows to ensure program effectiveness

·         Develop business plan, budgets, and performance monitoring

·         Lead as the HCC Coding Subject Matter Expert

·         Work with Senior Director to innovate additional program elements, including the strategic implementation of technology solutions to further improve the specificity and comprehensiveness of clinical documentation that drives appropriate risk adjustment

·         Oversee hiring, training, and supervision of a team of CDQI Manager and Clinical Documentation Specialists (CDS).

·         Utilize leadership, problem solving, and decision-making skills to motivate team members to meet business objectives and performance goals

·         Build a path for staff’s professional growth and career development, including ongoing professional education for the CDS

·         Create and lead a team culture of continuous process improvement and transparent accountability for clearly defined outcomes; use data to inform business




Education & Experience Requirements

                    Bachelors' degree from a top school; Master’s degree preferred

                    5+ years of experience in both strategic and operational roles within a health system, at a top tier management consulting firm, or within other industry that requires management of high-stakes, complex initiatives; experience in Nursing or Health Information Management preferred

                    2+ years of HCC Coding experience

                    Experience managing a team of at least two people (ideally more)

                    Interest in and demonstrated passion for healthcare required, experience with healthcare companies (e.g., delivery systems, insurance companies, start-ups) preferred

                    Credentials in one or more of the following, required:

o   Certified Coding Specialist (CCS)

o   Certified Risk Adjustment Coder (CRC)

o   Certified Professional Coder (CPC)


General Skills and Competencies

·         Strong manager – drives performance and cooperation within the team and with other quality initiatives; tailors career development for Clinical Documentation Specialists

·         Analytic skillset – able to complete financial analysis to inform business needs

·         Strategic thinker – natural strategic thinker, able to independently identify opportunities for individual team activities to improve and contribute to the overall business

·         Problem solver – responds to problems with suggested solutions; sound judgment and decision-making abilities

·         Organized – meticulous and detail-oriented; self-motivated and consistently meets timelines and objectives and empowers team to do the same

·         Reliable – takes accountability for consistent high-quality work from the team; proactively raises issues and decisions to senior leadership appropriately and in a timely manner

·         Mature professional – seen as a leader within the organization, interacts with internal and external stakeholders independently and in a professional manner

·         Effective communicator – excellent written and verbal communication; able to summarize analyses in a way that simplifies complex ideas and synthesize research into insights

·         Flexible team player – able to collaborate well with diverse set of team members, comfortable working in a start-up environment (which requires all team members to have the willingness to get things done)

·         Passionate innovator – desire to join a fast-paced, growth-oriented environment with a passion for delivering superior health value and improving health care in the US


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