ASC - RN Quality and Compliance

POSITION TITLE:  ASC – RN Quality and Compliance

FLSA Status:  Non-Exempt

POSITION RELATIONSHIPS:

• Reports to the Director of Ambulatory Surgical Programs

 POSITION SUMMARY:                                                                                                                                     

The ASC – RN Quality and Compliance performs the oversight functions of Quality, Safety, Infection Prevention, Pharmacy, and other duties as assigned. The Quality and Compliance RN will work closely with nurse management and the surgery center’s physician leadership to ensure standards are met, new standards are implemented as required, and regular quality auditing/reporting is conducted. The Quality and Compliance RN will also coordinate education activities to ensure continuing education for the clinical staff. 

The ASC – RN Quality and Compliance coordinates, provides and ensures documentation of surgery center compliance with all local, state, federal, company, and surgery center mandated standards and regulations.

ESSENTIAL FUNCTIONS/RESPONSIBILITIES:

• Facilitates compliance at multiple sites
• Maintains a cooperative relationship with clinical, business office, provider, and the governing bodies of each facility
• Completes required reporting in a complete and timely manner 
• Works with the surgery centers’ Operations Coordinator to provide statistical reports as requested
• Assists the nurse management team with monitoring compliance via chart review, facility walk-throughs, and other prescribed means
• Pro-actively works with physicians to obtain necessary documentation
• Pro-actively and remedially provides staff education to address deficiencies
• Oversees initial new hire orientation classes for perioperative staff. Assists nurse management with new-hire orientation, in addition to supporting current staff by conducting in-services and trainings. 
• Develops staff competency trainings and assists nurse management with ensuring staff compliance. 
• Coordinates rotations of nursing students. Attends nurse job fairs as needed. 
• Communicates needs and timely submits necessary reports to the Director of Surgical Programs 
• Participates in and helps guide surgery center QAPI meetings. 
• Participates in surgery center governance meetings as needed.
• Provides guidance to the surgery center Infection Preventionists in Infection Control surveillance, data collection, assessment, measurement, and reports findings to Director of Surgical Programs and other authorities as required
• Provides guidance and oversight of the surgery centers’ QAPI programs, including providing assistance to nurse management/quality nurses in quality surveillance, data collection, assessment, measurement, and reports findings to the Director of Surgical Programs and other authorities as required
• Serves as ancillary facility resource person for infection control and quality assurance for the surgery centers. 
• This role requires periodic travel to the AAESC, HRESC and SFASC to provide operational and/or departmental support.
• May be assigned to cover RN staffing as necessary.
• Promotes a safe and healthy work environment.
• The annual completion of assigned Learning Management System (LMS) courses is mandatory.  Any individual who has not completed their assigned training prior to November 30th of each year may be subject to disciplinary action, up to and including termination of employment.
• Other duties as assigned. 

SKILLS/QUALIFICATIONS:

• Must have Valid RN License to practice in the state of NM
• Must have Quality/Infection Control experience
• Prior experience with health facility accreditation surveys is preferred
• Possess the ability to work independently and prioritize responsibilities.
• Knowledgeable of policies and procedures specific to a nurse.
• Ability to work collaboratively with surgery center leadership, nurses, and clinical staff
• Previous experience in ophthalmology is preferred

PHYSICAL REQUIREMENTS:

• On feet/walks in excess of 8 hours a day. Assumes and maintains various postural positions including but not limited to kneeling, reaching, stooping, bending, and crouching. Repositions patients, transfers patients, push/pull patients in wheelchair and stretcher. Subject to stressful professional relationships.

Req.# 2780