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DCH Health System · 2 months ago

Quality Regulatory and Performance Improvement Specialist - RN

Tuscaloosa, AL

Full-time

Onsite

Mid Level

3+ years exp

DCH Health System is focused on providing high-quality patient care, and they are seeking a Quality Regulatory and Performance Improvement Specialist. This role involves monitoring regulatory standards, preparing for accreditation surveys, and driving performance improvement initiatives while serving as a resource for compliance with regulatory agency standards.

Health CareHospitalMedical

Responsibilities

Serves as PI resource to assigned PI Teams and facilitates use of performance improvement methods to improve quality and regulatory metrics

Conducts concurrent and retrospective Quality case reviews as assigned

Conducts assigned screening and measurement activities including data collection and analysis

Provides expertise in defined quality and regulatory related topics to drive process improvement and change management

Identifies and defines problems, collect data, establish facts and draw valid conclusions

Provides both formal and informal training relating to performance improvement and regulatory compliance

Engages department teams to maintain for system and regulatory requirements

Generates reports and communicates results and activities to administration, medical staff and other internal and external parties to support organizational improvement initiatives

Participates in collection, analysis and data reporting related to ongoing compliance efforts

Facilitates and actively participates in quality improvement teams

Self - directs and motivates to solve problems

Demonstrates strong knowledge of concurrent Quality Improvement methodologies and performance measures (i.e. PDSA, chart and graph interpretation)

Stays up to date on changes to Joint Commission Standards and CMS Regulations, interpreting and disseminating relevant information as needed

Responsible for assessing, monitoring, and recommending activities and educational opportunities to maintain compliance with accreditation and/or regulatory standards

Collaborates with interdisciplinary teams, including nursing, medical staff, quality improvement, and administration, to address compliance issues and drive organizational readiness for regulatory surveys and drive organizational readiness for accreditation and certification surveys

Through regular audits, identifies areas for improvement and facilitate corrective actions as needed

Actively participates in performance improvement initiatives and interdisciplinary hospital committees to promote high quality patient care and ensuring policy or process changes align with regulatory standards

Qualification

Quality Improvement methodologiesRegulatory compliance expertiseData analysisJoint Commission standardsCMS regulationsRegistered Nurse licensureCommunication skillsTeam collaborationProject managementConfidentiality

Required

Registered Nurse with current licensure for the state of Alabama

Minimum of three years' experience in an acute care facility

Clinical background that would facilitate assessment of patient care data for coordination of quality projects

Ability to work independently, and manage multiple projects, with strong prioritizing skills

Familiarity with Joint Commission and CMS standards and terminology

Basic knowledge of computers and office productivity software

Basic knowledge of data analysis

Ability to communicate effectively

Must be able to read, write legibly, speak and comprehend English

Ability to maintain confidentiality

Demonstrates independent skills, use of electronic emails, be a team player in relationship to working with others in groups and teams

Able to prioritize, organize and accomplish work

Keeping updated on technology and applying knowledge as applicable

Expected to have the ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or governmental regulations