Job Description
Responsible for planning, administering, and monitoring the consistent readiness of all quality management and quality improvement processes in partnership with the facility's leadership. Also responsible for overseeing and coordinating all facility efforts to monitor and maintain all regulatory and accreditation standards, as well as providing leadership in the development and measurement of the facility’s approach to quality and performance improvement.
Responsibilities
- Developing a quality improvement program for the facility.
- Initiating and overseeing the development of a comprehensive quality improvement program in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards.
- Reviewing the quality improvement program regularly in light of changing organizational needs, laws, policies, and procedures.
- Directing and coordinating quality initiatives in conjunction with facility leadership.
- Overseeing processes for data collection and analysis.
- Developing systems, policies, and procedures for performance measurement data.
- Collecting, summarizing, and analyzing performance data to identify opportunities for improvement and presenting findings quarterly to the committee and Board of Directors.
- Analyzing customer survey data to identify improvement opportunities and sharing findings with relevant departments.
- Leading the performance improvement department.
- Providing strategic oversight of proactive and reactive quality activities.
- Ensuring services are provided according to established standards.
- Overseeing reporting of events as required by regulatory agencies.
- Contributing to the department budget related to quality, such as information systems.
- Establishing relationships with external agencies involved in quality improvement, including purchasers, government agencies, and stakeholders.
- Educating and training leadership, staff, and business associates on the quality improvement plan and responsibilities.
- Communicating performance and safety activities regularly to the medical staff and engaging them in initiatives.
- Reviewing and evaluating services affected by quality, safety, and regulatory issues, making recommendations for improvement, and monitoring implementation.
- Leading and advising internal quality improvement teams.
- Planning and supervising daily activities, streamlining processes, and evaluating workload.
- Conducting performance evaluations and managing disciplinary actions.
- Identifying training needs and providing practical training on topics like conflict resolution, employment law, and performance management.
- Providing on-the-job training and orientation for team members.
- Acting as an expert on quality and safety issues in task forces and committees to establish priorities.
Qualifications
Required: 8-10 years of relevant experience in a similar industry, with at least 5 years of progressive leadership responsibility in a large organization.
Desired: Experience in a large healthcare facility.