Director of Quality and Risk Management

Job Description

Job Description

Community Health Partnership of Illinois is a is a non-profit organization that provides primary health care to migrant farmworkers and other medically underserved populations throughout northern and central Illinois that specializes in primary preventative medical, dental, and behavioral health service. Our focus is delivering quality, culturally responsive health care services to our patients, caregivers, and partners in the communities we serve

• Under the supervision and direction of the Vice President of Operations, the Director of Quality collaborates with management to develop plans and implement policies and procedures consistent with expectations, regulations and requirements established by governmental agencies and accrediting entities (e.g., HRSA, CMS, NCQA, Joint Commission).
• Implementation of the Quality Assurance and Improvement Program (QAIP) in alignment with the five (5) performance management (PM) phases : 1) establishing standards, 2) measuring performance, 3) reporting progress, 4) engaging in quality improvement, and 5) building a culture that supports quality, compliance, and high performance.
• Serves as the Risk Manager for the organization and implements a risk management patient safety plan in compliance with all HRSA requirements including FTCA.
• Oversees the Claims Management of the organization.
• Provides guidance and oversight of the risk, performance, and quality efforts conducted by all members of the organization. Routinely publishes and reviews performance data on all aspects of the organization.
• In collaboration with management, provides support and oversight of written guidance, training, and quality improvement (QI) projects to CHP providers and clinical teams to fulfill the goals and measurable objectives of performance standards and quality measures, as well as clinical quality measures (CQMs) .

Primary Responsibilities

1) Develops, implements and updates, as needed organization-wide quality and risk management plans to support ongoing continuous clinical performance improvement, including ongoing medical provider and clinic staff education and team building.

2) Oversees the Risk Management and Patient Safety Program and coordinates Risk Management activities with the Compliance Officer, including reviews of adverse health events and incident reports for trends and analysis to inform quality assurance / improvement activities, as well as adherence to policies and procedures in general.

3)Manages the Quality Assurance and Improvement Committee to support CHP clinical performance goals, identify and analyze opportunities for improvement using formalized QI methods (PDCA, PDSA, Lean and / or Six Sigma).

4) Manages the Risk Management Patient Safety Committee to support CHP risk mitigation and patient safety goals, identify and analyze opportunities to mitigate risk using formalized methods (ECRI, OIG, FTCA, etc.

5) Routinely issues reports on clinical quality and performance data at both the organization, provider and staff level, identifies opportunities for improvement, and shares findings in written reports to the Quality Improvement Committee, CHP management, and the CHP Board of Directors.

6) Achieves and maintains Patient Centered Medical Home recognition from the National Committee for Quality Assurance.

7) Submits annual applications for FTCA insurance coverage on a timely basis.

8) Communicates compliance and performance standards throughout the organization, operational and programmatic, with emphasis on achievement of CQMs.

9) Manages data collection, data validation, tracking of clinical quality and performance measures on a continuous basis for supporting program and staff evaluations and identification of areas of improvement.

10) Researches and implements evidence-based strategies designed to obtain measurable improvement in patient / community health outcomes (e.g., creation of patient-centered care teams, analysis, dissemination of patient satisfaction survey scorecards for each clinical team, etc.)

11) Serves on the Clinic Support Team, as an assistant to the Director of Strategic Initiatives, along with the Director of Operations, Medical Director, Dental Director, and Director of Behavioral Health to address integrated manner clinic staffing, improved patient health outcomes, increased efficiencies, and staff satisfaction.

12) Coordinates the tracking and analysis of clinical peer reviews and patient chart audits and monitoring corrective actions.

13) Collaborates with external partners and funders to enrich CHP’s QAI Program. Participates in grant- writing activities, as requested.

14) Performs other duties and assumes other responsibilities as determined in consultation with the Executive Director.

Requirements :