Process Research Director jobs in Rhode Island

Reporting to the Chief Medical Officer, The Director of Clinical Process Engineering will play a pivotal role in the development, implementation, and maintenance of clinical programs aimed at enhancing efficiency, quality, and patient outcomes. This individual will need to have a deep understanding of accountable care and value-based care models, as well as expertise in managing payor mixes and relationships within a healthcare setting.

Responsibilities:

• Lead the design, development, and optimization of clinical programs aimed at improving patient care delivery, enhancing operational efficiency, and achieving organizational goals, as directed by the Chief Medical Officer.
• Be responsible for the effective implementation of the Diabetes Management Project Work Plan, including needs assessment, strategic planning, and developing related external partnerships.
• Collaborate with cross-functional teams including physicians, nurses, administrators, and other stakeholders to assess current clinical processes, identify areas for improvement, and implement innovative solutions.
• Utilize continuous improvement methodology, including data analytics and performance metrics, to evaluate and improve the effectiveness of clinical programs and initiatives.
• Stay abreast of industry trends, regulations, and best practices related to accountable care, value-based care, and healthcare reimbursement models.
• Develop and maintain strong relationships with payors, managed care organizations, and other external stakeholders to negotiate contracts, manage risk, and optimize revenue streams.
• Provide leadership and guidance to clinical staff to ensure adherence to established protocols, standards of care, and regulatory requirements.
• Collaborate with IT and informatics teams to leverage technology solutions for streamlining clinical workflows, enhancing data capture and reporting capabilities, and supporting population health management initiatives.
• Serve as a subject matter expert and resource for clinical staff regarding process improvement methodologies, quality improvement initiatives, and best practices in clinical care delivery.

Qualifications:

• Bachelor's degree in healthcare administration, business administration, nursing, or a related field. Master's degree preferred.
• Minimum of 5 years of experience in healthcare management, clinical operations, or process improvement roles, preferably within a federally qualified health center or similar healthcare related setting.
• Strong understanding of accountable care organizations (ACOs), value-based care models, and alternative payment arrangements.
• Demonstrated experience in developing and implementing clinical programs, quality improvement initiatives, and care coordination strategies.
• Proven track record of effectively managing payor relationships, negotiating contracts, and optimizing reimbursement processes.
• Excellent analytical skills with the ability to interpret data, identify trends, and make data-driven decisions.
• Exceptional communication and interpersonal skills, with the ability to collaborate effectively with diverse stakeholders and lead multidisciplinary teams. Strong experience in direct clinician communication preferred.
• Strong project management skills with the ability to prioritize tasks, manage competing priorities, and drive results in a fast-paced environment.
• Knowledge of healthcare regulations, accreditation standards, and compliance requirements.
• Certification in Lean Six Sigma, Project Management Professional (PMP), or similar credentials preferred.