RN-Sr. Director-Quality Improvement-paid relocation Tampa, FL-tz98269 in Phoenix, Arizona

 
Essential Functions:
Analyzes, updates, and modifies standard operating procedures and processes to continually improve QI Department services/operations.
Assists in strategizing and facilitating various committee structures and functions to best address the QI process and oversees Quality Committees.
Oversight and interface internally and externally with pay for performance programs and initiatives
Coordinates and completes all QI activities required to meet national accreditation and regulatory performance improvement initiatives.
Collects and summarizes regional market performance data, identifies opportunities for improvement, and presents findings quarterly to the Performance Improvement Committee
Develops strategies for special program participation and Quality Improvement. Develops systems for close coordination of QI related functions with departments whose activities are directly a part of the QI Program, including Credentialing.
Supervises QI Specialists in the implementation of performance initiatives to drive HEDIS performance and contract compliance quality performance.
Communicates new state, federal and third party regulations and requirements to the staff.
Facilitates strategic and tactical planning for the quality improvement program, including needs assessments, evaluations, root cause analysis and interventions.
Collaborates with Health Services, Operations, and Information Technology departments to ensure full integration of quality improvement reporting for contract and accreditation compliance
Participates in site visit preparation and execution by regulatory and accreditation agencies (state agencies, URAC, NCQA, CMS, AAAHC, EQRO)
Leads, facilitates, and advises internal quality improvement teams
Actively participates on, or facilitates committees such as: Quality Improvement, Utilization Management, Patient
Safety, and Risk Management
Responsible for monitoring and evaluating staff performance.
Performs other duties as assigned
 Education:
 A Bachelor's Degree in nursing or a related health field, or equivalent years of related experience required; Master's Degree in Healthcare or Public Health, preferred.
 Experience:
10+ years of quality improvement experience
5+ years in Managed Healthcare
Excellent knowledge of JCAHO, URAC, AAAHC and NCQA standards
4+ years with Medicaid experience
5+ years management experience
Licenses/Certifications:
R.N. with active licensure (required)
Certification in Healthcare Quality by the Healthcare Quality Certification Board, or equivalent (preferred)  
Special Skills (e.g. 2nd language):
Excellent understanding of accreditation, federal and state regulations/requirements


Similar categories
Nearby Cities
Copyright © 2024 Americanlisted.com, All Rights Reserved.
Designated trademarks and brands are the property of their respective owners.