Director of Quality Assurance
15 days ago
Dallas
Job Description POSITION SUMMARY The Quality Assurance Director (QAD) is responsible for creating, directing, and evaluating projects and programs that advance the company’s mission and vision, the Quality Improvement/Quality Assurance Plan, and maintenance for all lines of business. The QAD engenders a culture of continuous improvement, innovation, and practice transformation that enhances patients’ clinical outcomes as well as overall patient and staff experience. The QAD utilizes health information technology, reporting tools, and data systems to support the activities of the clinical care teams at the point of care as well as planning changes to how care is provided to enhance outcomes. The QAD ensures high performance in regulatory compliance, value-based payment, and care-based incentive programs while assisting in communicating progress of quality improvement initiatives to the company’s staff, the Leadership, and other relevant stakeholders. The QAD strives to create and maintain working and learning environments that are inclusive, equitable and welcoming. This hybrid role requires candidates to reside in either Florida or Texas, as regular on-site collaboration at our locations in both states is essential. Travel between these locations will be a key part of the role to support team engagement and operational needs. ESSENTIAL DUTIES AND RESPONSIBILITIES The following duties are normal for this position. This list is not to be construed as exclusive or all inclusive. Other duties may be required and assigned. • Oversees Quality Improvement (QI) and Quality Assurance (QA) activities in collaboration with clinical and compliance leadership., • Collaborates with and guides leadership and clinical care team members to establish QI/QA processes throughout the organization., • Designs and employs QI/QA tools for use by clinical leadership to be implemented at the point of care, including order sets, documentation improvement, health maintenance flowsheets, and others as developed., • Supports QI/QA data collection and disseminates tools (reports, dashboards, etc.) to track and improve progress in all QI/QA initiatives., • Uses existing data systems to identify areas in need of QI across the organization., • Enables risk assessment in coordination with leadership to identify appropriate metrics and new collection sources and methods., • Oversees the data validation process and refines data management procedures for the collection and analysis of data., • Employs Plan-Do-Study-Act cycles (PDSAs) and other “tests of change” to design and disseminate optimal workflows in coordination with care teams, managers, etc., • Understands and applies National Committee for Quality Assurance (NCQA) concepts and designs, and supports new methods of care delivery to advance patient-centered care and quality., • Understands and enforces Federal, State, and Accreditation requirements including Conditions of Participation, Code of Federal Regulation, State Administrative Code, and all CMS regulatory guidelines., • Understands and employs Electronic Health Record (EHR) and healthcare analytical applications in analyzing, reviewing, and improving processes, policies, and systems to ensure they are aligned with current and updated standards., • Acts as QI/QA project manager and leads reporting mechanisms as needed at all levels of the organization., • Champions the adoption of standardized best practices and lessons learned across disciplines and departments at the care team level and at the organizational level using communication tools, published workflows, staff meetings, events, and trainings., • Assists in development, writing, and implementation of Policies and Procedures regarding Quality Improvement, Practice Transformation, and CMS STAR quality initiatives., • Identifies opportunities to support QI/QA efforts through evaluation testing, and/or integration of EHR functionality and other HIT systems., • Approaches change to the EHR or other HIT systems with consideration to data governance., • Understands data collection and reporting structures as defined by regulation (e.g., Uniform Data Set, Meaningful Use, etc.), health plan initiatives, and others as warranted., • Researches outside organizations, and partakes in training opportunities, and works with partners, consultants, and experts to guide QI/QA efforts., • Assess need for and facilitates education, training, and technical assistance for staff to ensure compliance with QI efforts., • Leads or participates in work teams related to QI and functions as a coach, where appropriate, to support care teams in building, fostering patient-centered care, and practice transformation. Job Expertise • Demonstrates knowledge of applicable clinical principles and practices., • Demonstrates knowledge and use of clinic policies and procedures as well as applicable federal and state rules and regulations., • Applies technical and procedural skills efficiently and effectively., • Successfully gathers and uses information, procedures, materials, equipment and techniques required for position., • Provides patient-centered customer service at all times., • Demonstrates the ability to anticipate patients’ needs and deliver services and respond to patients in a timely, accurate, courteous, respectful and friendly manner., • Demonstrates ownership, initiative, attention to detail, and follow-through., • Approaches problem-solving by focusing on patients first., • Oral and written communication is clear, concise, accurate, positive and respectful., • Demonstrates comprehension of oral and written questions, instructions, and information rapidly, thoroughly, and accurately., • Response to oral and written questions, instructions, and information is timely and appropriate., • Written communication is well-organized, legible, concise, neat, and in proper grammatical form., • Dealings with others are characterized by fairness, courtesy, diplomacy, honesty, firmness, empathy and confidence., • Effective in offering support and assistance to others, in obtaining information from others, and in supplying information to others., • Uses critical thinking and common sense to analyze situations, make timely and valid decisions, and take appropriate actions., • Demonstrates good judgment in making decisions., • Completes assigned duties and responsibilities in an accurate, timely and efficient manner., • Arrives to work on time and maintains consistent attendance., • Follows instructions and appropriate procedures., • Attend required annual in-service programs., • Comply with all trainings, drills, policies and procedures concerning safety., • 100% attendance to mandatory skills/competencies updates yearly required. Minimum Qualifications • Clinical, health care, or public health professional with at least two years of professional experience working in a health center or clinical setting., • At least five years of professional experience leading and managing teams and projects., • Proven and recurring success in directing and managing projects within the expected timeline., • Experience in program design, implementation, and evaluation., • Ability to multi-task, prioritize and work under deadlines., • Ability to strategize and plan as well as apply and track practical solutions., • Extensive knowledge and experience with industry-leading quality improvement methods and tools., • Proficient technology skills: MS Office applications (Excel, Visio, Word, PowerPoint), Outlook, Microsoft Teams, EHR systems., • Demonstrated ability to work across and lead various groups and teams., • Excellent communication (verbal and written) in English and presentation skills., • Bachelor’s degree in nursing from an accredited college or university., • Master’s degree in nursing, health administration, public health, or related field from an accredited college or university., • Certified in Healthcare Compliance (CHC) or Certified Professional in Healthcare Quality (CPHQ)., • Bachelor’s degree in nursing from an accredited college or university., • Master’s degree in nursing, health administration, public health, or related field from an accredited college or university., • Certified in Healthcare Compliance (CHC) or Certified Professional in Healthcare Quality (CPHQ)., • Knowledge of standard clinical healthcare practice policies and procedures., • Knowledge of billing, coding, HIM processes., • Knowledge of Strategic Healthcare Programs (SHP) platform., • Knowledge of Centers for Medicare and Medicaid Services (CMS) NCD, LCD, and COPs., • Knowledge of CMS Care Compare and STAR ratings., • Knowledge of Accreditation Commission for Health Care (ACHC) accrediting program(s)., • Experience working on computers and knowledge of Microsoft Office software products., • Ability to work with practice management and EHR systems., • Knowledge of health insurance plans., • Knowledge of healthcare terminology, procedures, and practice., • Knowledge of HIPAA regulations., • Knowledge of data warehousing, analytics, and visualization., • Excellent verbal and written communication skills., • Knowledge of personnel management and labor laws as it relates to the position., • Ability to work independently and use good judgment., • Ability to work effectively and harmoniously with co-workers., • Possess empathy towards the needs of others with excellent leadership and coaching skills. The physical demands described below are representative of those that must be met by an individual to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the Team Member is regularly required to talk or hear. The Team Member is frequently required to sit; use hands to finger, handle, or feel and reach with hands and arms. The Team Member is occasionally required to stand and walk. The Team Member must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, depth perception and ability to adjust focus.
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