Performance Excellence & Compliance Director

Universal Health Services; Whitemarsh Township (Montgomery County); On-site; USD 120,000 - 190,000; Full time

Job summary

Brooke Glen Behavioral Hospital in Fort Washington, PA, part of Universal Health Services, seeks a Director of Performance Improvement and Compliance to support the CEO in advancing mission and objectives. The role oversees hospital-wide PI programs, ensures regulatory compliance, and guides data-driven decision making across departments.

The ideal candidate has a Bachelor's in a behavioral health field and at least four years in quality management within an acute psychiatric setting, with

Qualifications

• Bachelor's degree in nursing, social work or related behavioral health field preferred or equivalent combination of education and experience.
• Minimum of four years' experience in quality management/improving organizational performance within an acute psychiatric treatment setting preferred.

Responsibilities

• Develop, manage and coordinate hospital-wide Performance Improvement activities to advance clinical outcomes and patient experience.
• Supervise PI activities daily and assure timely action.
• Train staff in performance improvement and compliance program.
• Chair the hospital's Quality Council and report to MEC and Governing Board.
• Develop methods for obtaining required data/information.
• Maintain facility information on corporate UHS Clinical Services Performance Manager.
• Ensure monthly PI Indicator Entry is completed timely.
• Monitor PI Dashboard scores against benchmarks.
• Oversee patient satisfaction survey completion.
• Report PI data and survey outcomes to committees and Governing Body.
• Aggregate and analyze data from internal and external sources.
• Advise/assist departments accountable for PI activities.
• Coordinate reports of findings to relevant bodies.
• Participate in committee meetings where PI activities occur.
• Ensure hospital meets regulatory expectations with program policies.
• Perform other duties as assigned.

Skills

Quality management

Performance improvement

Compliance

Hospital operations

Education

Bachelor's degree in nursing or related behavioral health

Job description

Brooke Glen Behavioral Hospital in Fort Washington, PA, part of Universal Health Services, seeks a Director of Performance Improvement and Compliance to support the CEO in advancing mission and objectives. The role oversees hospital-wide PI programs, ensures regulatory compliance, and guides data-driven decision making across departments.

The ideal candidate has a Bachelor's in a behavioral health field and at least four years in quality management within an acute psychiatric setting, with