Quality Assurance Director-Clinical QA/QI

Job Description

Job Description

A licensed RN or Nurse Practitioner with experience in quality improvement within a healthcare setting will also be considered.

POSITION SUMMARY :

The QA Director will Plan, coordinate, and implement the quality management and quality improvement programs for the health center, ensuring compliance with regulatory requirements and accreditation standards.

The QA director will collaborate with management team members to develop quality assurance plans, work with employees to implement the strategies, review documents for accuracy and monitor patient satisfaction.

The QA Director engenders a culture of continuous quality improvement, innovation, and practice transformation that enhances patients’ clinical outcomes as well as patient and staff experience.

The director utilizes health information technology, reporting tools, and data systems to support the activities of the clinical care team at the point of care as well as in the planning of changes to how care is provided.

RESPONSIBILITIES : Quality Assurance

Quality Assurance

1. Reviews Quality Assurance standards, studies existing policies and procedures, and interviews personnel and patients to evaluate effectiveness of quality assurance program.

2. Reviews, evaluates the work of professional, technical and clerical staff; interprets and implements Quality Assurance standards based on findings.

3. Directly supervises the Quality Assurance / Improvement team

4. Applies PDSA (Plan-Do-Study-Act) analytical strategies to assess and implement continuous improvement initiatives and presents findings at senior management team meetings

5. Monitors unusual occurrences, report follow-up procedures, and report monthly and year to date comparisons. Responds to clinical incident reports as submitted by managed care plans and patients.

6. Develops Quality Assurance policies to ensure successful implementation of improvement standards.

7. Reviews and evaluates patients’ medical records, applying quality assurance criteria.

8. Implements and coordinates the provider peer review quarterly process.

9. Go to clinical sites to observe and monitor QA / QI implementation such as pre-visit planning huddles.

10. Compiles statistical data and writes narrative reports summarizing quality assurance findings and collaborates with the clinical informatics specialist.

11. Understands and applies National Committee for Quality Assurance (NCQA) PCMH concepts, and designs and supports new methods of care delivery and care team organization to advance patient-centeredness and quality.

Understands data collection and reporting structures as defined by regulation (eg UDS - Uniform Data Set, Meaningful Use, etc.

health plan incentives (ie Value-Based Care Incentive Program), and others as warranted.

12. Provides assistance to managers with the coordination of audit information, and recommends appropriate data gathering mechanisms, procedures, etc.

13. Responsible for achieving a satisfactory working environment between other departments performing Quality Assurance studies.

14. Assists the CMO with revisions to the QA / UR plan per requirements of HRSA.

15. Maintains current and accurate records of all relevant communications, audits, corrective action plans, and effectiveness of monitoring.

16. Oversee the maintenance and enhancement of Patient-Centered Medical Home (PCMH) certification.

17. Assists in preparation and coordination of regularly-scheduled QI / QA meetings with QA Director and performs all necessary follow-up duties, including clarifying and tracking action items and documentation of minutes, participants, and resulting activities

18. May be required to perform other duties as assigned or when necessary. If such work becomes a permanent and regular part of the job, a new description will be prepared.

MINIMUM QUALIFICATIONS :

1. Master’s degree in healthcare administration, public health, or related field preferred. A licensed RN or Nurse Practitioner with experience in quality improvement within a healthcare setting will also be considered.

2. Experience with electronic health records (EHR) and health informatics.

3. Experience in maintaining and enhancing patient centered medical home (PCMH) certification.