National Association of Latino Healthcare Executives · 11 hours ago
Quality and Safety Oversight Specialist V (KFH/HP) Atlanta, GA
Atlanta, GA
Full-time
Onsite
Senior LevelThe National Association of Latino Healthcare Executives is focused on enhancing healthcare quality and safety. The Quality and Safety Oversight Specialist V develops quality strategies, oversees quality committees, and serves as a subject matter expert in clinical quality processes and regulations to improve patient safety and care quality.
Health CareHospitalMedical
Responsibilities
Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit. Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams
Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals. Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others
Serves as the subject matter expert for clinical quality improvement processes and regulations practitioners, Quality Specialists, department managers, and peers, projects/committees, and internal stakeholders by: providing consultation on the interpretation and interaction of current policies, and how they interact with the current climate, and potential changes to regulations and legislation; serving as a technical advisor on committees, projects to drive discussions on drawing guidelines on the enforcement, development of policies or procedures of regulations and auditing processes; maintaining collaborative, results oriented partnerships with practitioners and/or staff across clinical and administrative roles to ensure compliance with regulations and improve patient safety, reporting accuracy, and health outcomes and provides insight to the regulation climate; developing educational programs to raise awareness for current and changes in regulation requirement, internal concerns, and system/database usage; and anticipating issues, weighing practical and technical considerations in addressing issues, and coordinating with the appropriate stakeholders to develop resolutions
Develops the quality of care complaints and the review process by: coordinating grievance meetings, cases, reviews, referrals, or other mechanisms by collaborating with the ombudsman and external regulatory services; responding to and directing the preparations of all documentation, records, and information requested for specific patient case reviews; ensuring consistent follow through on quality of care concerns and analyzing and managing the process flow of investigations and claims for potential errors, red flags, and areas of improvement; and monitoring critical quality improvement metrics, cases, quality care incidents, and near misses according to established protocols on an ongoing basis
Researches and investigates infection prevention and control programs to improve employee and patient safety by: conducting epidemiological research and investigations of significant clusters of infection or serious communicable disease concerns. as a part of prevention, surveillance, and outbreak management; assisting with the coordination of outbreak containment efforts within the area of focus; and consulting with Administration on infection control implications of architectural design, renovation, and construction
Develops risk management efforts by: researching corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials, patient satisfaction surveys, and auditing surveys; serving as a subject matter expert for internal and external policies, regulations, scientific research, and legislation related to quality improvement; conducting complex root cause analysis, failure mode and effect analysis, and other assessments in response to significant events, near misses, and good catches in order to identify areas of improvement and evaluate newly internalized processes and programs; and exercising independent judgment to escalate high-risk issues and trends to appropriate entity for resolutions
Develops patient safety programs and initiatives by: developing and monitoring the procedures for reporting safety hazards, accidents, incidents, threats, and significant events in line with best practices; and developing and revising patient strategies based on patient outcomes and leading improvement activities, safer patient practices and services, and seamless transition of care
Provides consultation for the development of new clinical quality improvement programs by: consulting with teams and departments to develop guidelines, metrics, and operational definitions of quality improvement through qualitative and quantitative program evaluation, analyzing program performance, and peer/department review groups by challenging groups to provide creative solutions; leveraging a variety of health concepts, regulatory requirements, and change management principles to develop programs which optimize clinical quality, safety, or health outcomes; and researching and investigating innovative opportunities to develop KPs capacity as a learning organization, increasing capacity in areas such as video ethnography, patient-reported outcomes, and harvesting of best practices
Develops and implements systems, procedures, and forms to improve data management programs and utilizes data to monitor and improve performance of all worker and patient safety programs by: ensuring the quality improvement monitoring agenda for assigned departments includes all aspects of data management and analysis of trends and patterns of practice; conducting descriptive inferential, reliability, and confidence intervals statistical analysis for routine and special projects related to quality improvement evaluations; developing the procedures for gathering and entering data from databases, vital statistics, hospital patient discharge data, claims, and other relevant health sources; and analyzing and presenting reports (e.g., infection control research, utilization reviews, population health needs analysis, patient satisfaction) into specified formats for internal stakeholders and working with departments to develop action plans
Develops the process for regulatory audits and survey efforts by: serving as a liaison between external evaluators, vendors, and departments for onsite visits and evaluations; delivering ad hoc and complex requested audit documentation, information, reports, and tools throughout the auditing process; assessing the workflow of completing auditing surveys to identify gaps in completion and reporting; and conducting routine mock audits and surveys within departments to ensure auditing and survey preparedness
Seeks and addresses feedback from the evaluation of the cost effectiveness, practicality, and appropriateness of medical care given to patients by: creating the reports to be used in complex case reviews with senior leaders and practitioners; analyzing current standard operating procedures for treatment for specific medical codes to ensure equal and timely access to care and escalates concerns or improvements to senior leaders; analyzing current patient treatment plans to ensure patient needs are met in a timely manner and escalates issues to senior leaders; leading discussions with practitioners, staff, and patients to identify population health needs, such as community health concerns, access to transportation, knowledge of rights, reducing no shows, and others, and providing recommendations to senior leaders; and analyzing previous patient cases to identify areas of improvement for length of stay, type of treatment, and time of treatment, and reporting recommendations to the Manager
Qualification
Required
Develops quality strategies in alignment with KFHP strategic priorities, mission, and vision
Orchestrates across areas to recommend actions based on reviews of regional quality reports
Identifies opportunities for improvement and establishes priorities
Recommends actions to senior leadership to improve clinical quality
Determines accountability and ensures quality issues are identified and resolved
Serves as a subject matter expert for clinical quality processes and regulations within a specified area
Takes on informal leadership positions to review and act on results of data analysis
Monitors corrective action plans and reviews and approves quality policies
Oversees and coordinates the functions of Quality Committees and subcommittees
Annually approves Quality Program description, work plans, and annual evaluations
Promotes learning in others by communicating information and providing advice to drive projects forward
Builds relationships with cross-functional stakeholders
Listens, responds to, seeks, and addresses performance feedback
Provides actionable feedback to others, including upward feedback to leadership
Mentors junior team members
Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas
Influences team members within assigned team or unit
Adapts to competing demands and new responsibilities
Adapts to and learns from change, challenges, and feedback
Models team collaboration within and across teams
Conducts or oversees business-specific projects by applying deep expertise in subject area
Promotes adherence to all procedures and policies
Partners internally and externally to make effective business decisions
Determines and carries out processes and methodologies
Solves complex problems; escalates high-priority issues or risks, as appropriate
Monitors progress and results
Develops work plans to meet business priorities and deadlines
Coordinates and delegates resources to accomplish organizational goals
Recognizes and capitalizes on improvement opportunities
Evaluates recommendations made
Influences the completion of project tasks by others
Serves as the subject matter expert for clinical quality improvement processes and regulations
Provides consultation on the interpretation and interaction of current policies
Serves as a technical advisor on committees and projects
Maintains collaborative, results oriented partnerships with practitioners and/or staff
Develops educational programs to raise awareness for current and changes in regulation requirement
Anticipates issues, weighing practical and technical considerations in addressing issues
Coordinates with the appropriate stakeholders to develop resolutions
Develops the quality of care complaints and the review process
Coordinates grievance meetings, cases, reviews, referrals, or other mechanisms
Responds to and directs the preparations of all documentation, records, and information requested for specific patient case reviews
Ensures consistent follow through on quality of care concerns
Analyzes and manages the process flow of investigations and claims for potential errors
Monitors critical quality improvement metrics, cases, quality care incidents, and near misses
Researches and investigates infection prevention and control programs
Conducts epidemiological research and investigations of significant clusters of infection
Assists with the coordination of outbreak containment efforts
Consults with Administration on infection control implications of architectural design
Develops risk management efforts
Researches corrective action plan for areas of improvement identified through utilization review
Serves as a subject matter expert for internal and external policies, regulations, scientific research, and legislation related to quality improvement
Conducts complex root cause analysis, failure mode and effect analysis, and other assessments
Exercises independent judgment to escalate high-risk issues and trends
Develops patient safety programs and initiatives
Develops and monitors the procedures for reporting safety hazards, accidents, incidents, threats, and significant events
Develops and revises patient strategies based on patient outcomes
Provides consultation for the development of new clinical quality improvement programs
Consults with teams and departments to develop guidelines, metrics, and operational definitions of quality improvement
Analyzes program performance and peer/department review groups
Researches and investigates innovative opportunities to develop KPs capacity as a learning organization
Develops and implements systems, procedures, and forms to improve data management programs
Utilizes data to monitor and improve performance of all worker and patient safety programs
Ensures the quality improvement monitoring agenda for assigned departments includes all aspects of data management
Conducts descriptive inferential, reliability, and confidence intervals statistical analysis
Develops the procedures for gathering and entering data from databases
Analyzes and presents reports into specified formats for internal stakeholders
Develops the process for regulatory audits and survey efforts
Serves as a liaison between external evaluators, vendors, and departments for onsite visits
Delivers ad hoc and complex requested audit documentation, information, reports, and tools
Assesses the workflow of completing auditing surveys to identify gaps in completion and reporting
Conducts routine mock audits and surveys within departments
Seeks and addresses feedback from the evaluation of the cost effectiveness, practicality, and appropriateness of medical care given to patients
Creates the reports to be used in complex case reviews with senior leaders and practitioners
Analyzes current standard operating procedures for treatment for specific medical codes
Analyzes current patient treatment plans to ensure patient needs are met in a timely manner
Leads discussions with practitioners, staff, and patients to identify population health needs
Analyzes previous patient cases to identify areas of improvement for length of stay, type of treatment, and time of treatment
Company
National Association of Latino Healthcare Executives
The National Association of Latino Healthcare Executives is a hospital and healthcare organization.
Founded in 2005
11-50 employees
Funding
Current Stage
Early StageLeadership Team
Jackie Sifuentes, MBA, LSSYB
Co-Founder La Mesa Emerging Leaders Mentorship Program for Early Careerists
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