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Signet Health · 5 hours ago

Director of Quality and Risk Management

Midland, TX

Full-time

Onsite

Lead/Staff, Director/Executive

2+ years exp

Signet Health is seeking a Director of Quality and Risk Management who will provide strategic leadership and operational oversight for the hospital’s quality improvement, patient safety, and risk management programs. The role involves ensuring compliance with various regulatory requirements while fostering a culture of safety and continuous performance improvement.

ConsultingHealth Care

Responsibilities

Lead the hospital’s Quality Assessment and Performance Improvement (QAPI) program in accordance with CMS Conditions of Participation and accreditation standards

Develop, monitor, and report quality metrics relevant to inpatient psychiatric care

Analyze quality and risk data to identify trends and opportunities for improvement

Facilitate performance improvement projects, including root cause analyses and action plans

Prepare quality reports for executive leadership, medical staff, and the Governing Body

Direct the hospital’s risk management program, including incident reporting, investigation, tracking, and follow-up

Oversee review and response to adverse events, near misses, and sentinel events

Coordinate Root Cause Analyses (RCA) and Failure Mode and Effects Analyses (FMEA)

Monitor behavioral health-specific risks such as suicide/self-harm, elopement, aggression, restraint and seclusion, and environmental safety

Partner with leadership to implement risk reduction strategies and corrective action plans

Ensure compliance with CMS Conditions of Participation, state licensing requirements, and accreditation standards

Serve as the primary point of contact for regulatory surveys and inspections

Coordinate survey preparation, on-site support, and post-survey corrective actions

Maintain policies, procedures, and documentation related to quality and risk

Track regulatory changes and communicate impacts to leadership

Promote a culture of safety, transparency, and continuous improvement

Support staff education related to quality and patient safety

Encourage incident and near-miss reporting using just culture principles

Provide consultation to department leaders on quality and risk concerns

Collaborate with the CEO and department leaders to align quality initiatives with organizational goals

Participate in leadership and quality committees

Provide oversight to quality and risk staff, if applicable

Qualification

Quality ManagementRisk ManagementRegulatory ComplianceHealthcare Quality PrinciplesAnalytical SkillsProfessional JudgmentCommunication SkillsCollaboration SkillsProblem-Solving Skills