SUMMARY:

Coordinates the development, implementation, and evaluation of the medical centers overall quality improvement (QI), safety, and infection control programs to identify trends, prioritize and recommend improvements, and ensure National Committee for Quality Assurance (NCQA) and Occupational Safety and Health Administration (OSHA) compliance. Provides direction/oversight of activities related to clinical services by licensed and certified clinical support staff, ensure consistency in practice standards, and facilitate an interdisciplinary team approach to the delivery of care. Investigate incident reports, patient complaints, patient care issues, and other issues as requested by supervisor.

SCHEDULE/HOURS:

• Full Time
• Monday - Friday
• Typically 8:00 am - 5:00 pm
• Rarely weekends

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Provide direction, training, and discipline to licensed and certified clinical support staff and corporate referral associate. This includes, but is not limited to, coordinating online portal set up and training for Stericyle, VFC, and others as appropriate.
• Supervise, provides direction, training, and discipline to the Clinical Quality Gap Analyst and corporate Referral Associate.
• Provides or facilitates training to all staff as required to meet OSHA and FTCA requirements in coordination with the Risk Manager.
• Implements and maintains comprehensive center-wide Quality Improvement, safety, and infection control programs including risk management in conjunction with the Risk Manager. The program includes coordinating and leading Clinical Quality Improvement meetings at least semiannually and monthly with center managers.
• Conducts clinical compliance, quality indicator, and risk management investigations (in conjunction with the Risk Manager) and identifies opportunities for improvement, coordinates interventions, and tracks and monitors clinical performance improvement plans.
• Collaborates with health care providers in identifying opportunities and initiating strategies for improving performance, and provides formal and informal education for all aspects of quality management program activities including complaints, quality indicators, clinical guidelines, and prevention and treatment services.
• Monitors provider records, policies/procedures and other sources of data for compliance with medical records standards, preventive screening guidelines, clinical pertinence criteria, clinical quality indicators and other guidelines consistent with quality management program activities.
• Tracks, trends, analyzes and presents data from quality management activities, presents projects, and educates providers and clinical staff as indicated.
• Helps to gather data and prepares reports for National Committee for Quality Assurance (NCQA) accreditation and other accrediting/regulatory agencies. Activities include, but are not limited to, running reports from the EMR system to include UDS reporting, coordinating and reviewing survey data, and data provided by center managers.
• Develop and implement clinical policies and procedures in accordance with accepted standards and regulatory compliance.
• Maintain strictest confidentiality.
• Any other duties as assigned.

EDUCATION AND EXPERIENCE:

• Bachelor’s degree in nursing and current Florida RN license to practice in Florida.
• Minimum of four years experience in health care setting with minimum of three years experience in quality management.
• Experience in, and/or experience with, chronic diseases and disease self-management.

QUALIFICATIONS and SKILLS:

• Knowledge of TQM concepts, methods and tools including understanding of NCQA, HEIDIS, and risk management.
• Working knowledge of computer, computer systems and applications.
• Knowledge of medical records and clinical care processes, safety and infection control guidelines.
• Skill in effective education and facilitation of TQM efforts in medical and dental centers.
• Skill in understanding of analytical methods and statistical software packages by developing appropriate reports.
• Skill in facilitation of issue identification/resolution with a variety of audiences.
• Ability to communicate knowledge effectively both verbally and in written form in informal and formal settings.
• Ability to work independently and to plan and organize time appropriately.
• Demonstrated initiative, ability to work with others, and good professional judgment.