Apply on Employer Site

The Cigna Group · 2 months ago

Chief Clinical and Quality Officer

St Louis, MO

Full-time

Onsite

Director/Executive

15+ years exp

The Cigna Group is dedicated to improving health and vitality, and they are seeking a Chief Clinical Quality Officer (CCQO) to oversee the quality and safety of healthcare services. This role involves leading initiatives that ensure patient-centered care and compliance with healthcare standards, while collaborating with various teams to enhance patient outcomes.

CommercialHealth CareHospitalInsuranceMedical

Responsibilities

Develop and implement quality improvement and outcome strategies aligned with organizational goals

Collaborate with stakeholders to set and monitor key performance indicators (KPIs) related to healthcare quality and outcomes

Oversee quality assurance programs to ensure compliance with local, state, and federal regulation and with healthcare quality standards, including HIPAA, JCAHO, and CMS as well as HEDIS, NCQA Health Plan Ratings, STARS, and CAHPS compliance

Identify and mitigate risks related to healthcare quality and implement continuous improvement methodologies like Six Sigma or Lean Healthcare

Lead the development and implementation of a robust clinical safety framework across all care and health services delivery settings

Oversee incident reporting systems, root cause analyses (RCA), and failure mode and effects analyses (FMEA) to proactively identify and mitigate risks

Establish and monitor clinical safety KPIs, including adverse event rates, sentinel events, and near misses

Collaborate closely with legal, compliance and FWA teams

Ensure timely investigation and resolution of safety events, with transparent reporting to leadership and regulatory bodies

Collaborate with clinical leaders to embed evidence-based safety protocols and promote a culture of high reliability

Champion infection prevention and control programs, medication safety initiatives, and patient harm reduction strategies

Collaborate with stakeholders to develop business cases and monitor performance

Lead and develop a multidisciplinary team focused on clinical excellence, quality and safety

Foster a culture of continuous improvement and innovation

Represent the department in executive meetings and external forums

Collaborate with internal entities, healthcare providers, and members/patients to improve quality and integration of interventions

Engage with industry experts and participate in relevant forums and committees

Qualification

MDDO with board certificationHealthcare quality standardsLeadership experiencePatient experience strategiesData analyticsInnovationStakeholder engagementStrategic thinkingCommunication skillsTeam management

Required

MD or DO with board certification

15+ years of leadership experience in a large healthcare organization, including 5+ years in direct leadership of patient experience and quality improvement

Strong knowledge of healthcare quality standards and patient experience strategies

Excellent leadership skills, strategic thinking, and ability to execute for results in a complex commercial environment

Proven ability to innovate and drive organizational change

Experience in a highly matrixed organization with strong internal enterprise relations

Strong communication skills, with the ability to translate complex topics into consumable formats