Quality Operations Manager
The Quality Operations Manager is responsible for executing and supporting quality programs and oversight of daily quality improvement activities supporting the Quality Management program. This person will work with cross functional team members.
Essential Functions:
Responsible for the translation, planning, and operationalizing the Quality Management strategy to meet the requirements of contractual, regulatory and NCQA requirements
Identifies and monitors measures of effectiveness for the overall CKD and ESRD programs for improvement opportunities.
Works closely with data and informatics to identify measure requirements.
Performs qualitative and quantitative analysis on quality measures.
Collaborates with all departments to implement continuous quality improvement. Acts as a subject matter expert for performance improvement best practices.
Prepares reports, data and presents projects to external and internal entities.
Performs chart audits for internal programs for compliance with NCQA, regulatory and contractual/delegated requirements.
Assists the Quality and Patient Safety Team with strategic performance improvement initiatives throughout the organization.
Reports quality measure results to Medical Staff, assists them with interpretation of results.
Actively participates in and/or leads committees and meetings that are focused on quality, safety and performance improvement measurements at the direction of the Director of Quality.
Identifies and implements educational materials and agendas for all organization stakeholders to ensure continuous quality improvement.
Develops action plans for all non-compliant standards with measurement of effectiveness.
In coordination with the Director of Quality and accreditation manager, assists with all NCQA survey activities from preparation to submission.
Provide support and guidance to the clinical leadership in meeting the goals within the accreditation and patient safety. Works closely with the market’s clinical leadership to implement pilot programs designed to eliminate the following: preventable mortality, adverse drug events, falls, pressure ulcers, surgical complications, nosocomial infections, and other patient safety goals.
Supports the collection of regulatory driven patient safety data for trends and recommend changes, as appropriate, thereby improving the safety of care.
Reviews and evaluates services to ensure that safety and regulatory recommendations are implemented and desired results are obtained.
All other duties as assigned.
BS or MS in health care field preferred
5 years in Health Care Quality or Performance Improvement
Maintains oversight responsibility for all performance improvement activities conducted throughout the markets.
This position will assist with develop met of key quality performance indicators and monitor the programs data.
Establishes collaborative relationships with team members to ensure that quality data trends are identified and reviewed. Corrective actions are taken if necessary.
Monitors and maintains statistics necessary to measure the effectiveness of various quality data efforts using dashboards
Monitors and maintains data on Quality rates in a monthly report to the Quality Director.
Works in collaboration with the Clinical Manager to maintain the data on clinic compliance ensuring that standard operation procedures are being completed and adjusted if need.
Conducts staff trainings and seeks training opportunities within the community to enhance support services and staff knowledge.
Drive the implementation of integrated and comprehensive data-driven Quality Improvement activities, procedures, and policies to ensure compliance with regulatory requirements and SOPs and to ensure a continued state of inspection readiness.
Minimum Qualifications
Bachelor's Degree in related field (preferably nursing) or an equivalent combination of education and experience.
3 - 5 years' Healthcare Quality experience, health plan experience a plus
Preferred Qualifications
Registered Nurse License
Ability and passion for educating
Strong organizational skills, customer service, relationship development, results orientation, team building and decision-making abilities
Understanding of Value Based Care
Proven to excel in a start-up environment
Experience leading virtual teams
Easily builds rapport with internal, cross-functional teams
Outstanding verbal, written and presentation skills
Excellent interpersonal communication and negotiation skills
Committed to continuous improvement
Aligns with Strive's core values: Care for others first, innovation, tenacity, resilience and fun!