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Covenant Health · 9 hours ago

MGR QUALITY CARE MGMT

Knoxville, TN

Full-time

Onsite

Senior Level

5+ years exp

Covenant Health is East Tennessee’s largest nonprofit health system, recognized for its exceptional care and advanced medical technology. The Manager of Quality & Care Management is responsible for overseeing the operations of quality, care management, and regulatory compliance, ensuring effective coordination of care and performance improvement across assigned facilities.

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Responsibilities

Develops department budgets that reflect effective management of resources to provide services

In collaboration with enterprise leadership, facility leadership, and medical staff, assists in the development of strategic initiatives for the department and facility

Collaborates with interdisciplinary groups and leaders to identify and monitor key processes and patient outcomes. Uses various data sources, including but not limited to, publicly reported data to inform which processes and outcomes to monitor. Facilitates effective communication of results to medical staff and other key stakeholders

Identifies opportunities for improvement using Covenant performance improvement methodologies to implement corrective action plans and evaluate results for desired outcomes

Manages Care Management functions to ensure the coordination of care for patients so they move seamlessly through the continuum of care

Stays abreast of regulatory, licensing, and certification (Joint Commission, CMS, Leapfrog, State, etc.) standards to ensure processes are in place to achieve desired outcomes

Collaborates with the Peer Review/PQPR medical staff chair to operationalize assessments of peer review triggers and functions of the facility medical staff

Collaborates with clinical and medical staff to implement processes, as needed, to ensure financial and length of stay metrics are assessed and communicated to applicable medical staff and organizational leaders

Operationalizes a Care Management Model to ensure timely and effective throughput through the continuum of care. Serves as a coach, mentor, and role model for all team members

Oversees activities of medical staff credentialing, FPPE/OPPE, and departmental organization including, but not limited to, facilitating applicable medical committee meetings to ensure effective patient safety and regulatory compliance

Collaborates with enterprise infection prevention management and local leaders to assess and support the infection prevention strategies as needed

Oversees survey action plans and ongoing assessments of regulatory readiness for all accreditation, certification, and state surveys

Collaborates with nursing, medical staff, and other disciplines to assess and improve outcomes related to performance with various measures associated with publicly reported entities

Proactively seeks opportunities to reduce waste and redundancy in the utilization of resources

At a minimum participates in the Quality, Peer Review, Regulatory, Infection Prevention, and Credentials Committees. The Quality Manager may serve as the committee facilitator as needed

Communicates with medical staff to improve utilization of resources and compliance with evidenced based care as deemed necessary

Collaborates with medical staff and facility leadership to determine the frequency, quality, and monitoring of multidisciplinary rounds

Provides data to stakeholders on an ongoing basis to inform stakeholders on progress towards applicable enterprise and business unit clinical and operational goals

Local travel required

Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested

Performs other duties as assigned

Qualification

Quality Improvement PrinciplesRegulatory ComplianceCare Management StandardsBudget ManagementTennessee RN LicenseCCM CertificationACM CertificationCPHQ CertificationCollaborationCommunicationLeadershipMentoring