DIRECTOR OF QUALITY & RISK MANAGEMENT

SUMMARY

Management to lead our comprehensive quality improvement and risk mitigation programs, including the development and oversight of a Chronic Care Management (CCM) program. In this critical leadership role, you will play a pivotal role in ensuring exceptional patient care, optimizing clinical processes, safeguarding the organization from potential risks, and improving health outcomes for patients with chronic conditions.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

- Develop, implement, and oversee a comprehensive Quality Management program that aligns with industry best practices, regulatory requirements, and includes the creation and maintenance of a Chronic Care Management (CCM) program.

- Lead a team of quality specialists and risk management professionals in conducting audits, data analysis, root cause investigations, and program evaluations specifically related to the CCM program.

- Identify and implement strategies to minimize risks, prevent errors, and ensure patient safety, with a particular focus on managing chronic conditions through the CCM program.

- Analyze quality data, trends, and performance metrics related to the CCM program to identify areas for improvement and develop corrective action plans.

- Collaborate with physicians, nurses, care coordinators, and other healthcare professionals to promote a culture of safety, quality, and effective chronic disease management within the organization.

- Oversee the development and implementation of effective risk management strategies, including incident reporting, risk identification, and mitigation plans, while considering the unique needs of the CCM program.

- Ensure compliance with all applicable healthcare regulations and accreditation standards specific to chronic care management.

- Stay abreast of industry trends and best practices in quality, risk management, and chronic care management.

- Provide ongoing education and training to staff on quality, risk management principles, and chronic care management best practices.

- Develop and maintain a positive working relationship with internal and external stakeholders, including regulatory agencies, accrediting bodies, and community partners relevant to chronic disease management.

- Prepare comprehensive reports on quality, risk management activities, and the performance of the CCM program for leadership review.

- Manage the Quality and Risk Management budget effectively, including budgeting for the CCM program.

LANGUAGE SKILLS

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.  Ability to write reports, business correspondence, and procedure manuals.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

REASONING ABILITY

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to apply fair judgment to resolve problems involving several concrete variables in standardized situations.

OTHER REQUIRED SKILLS

Proficient and accurate typing skills.  Excel and Word experience. Telephone etiquette. Attention to details.

Qualifications

QUALIFICATIONS

- Proven track record of success in developing, implementing, and maintaining quality improvement and risk management programs in a healthcare setting, including experience with chronic care management programs.

- Strong analytical and problem-solving skills.

- Excellent communication, interpersonal, and leadership skills.

- Ability to work independently and as part of a team.

- Proficient in Microsoft Office Suite and healthcare quality management software (preferred).

EDUCATION and/or EXPERIENCE

- Master's degree in Healthcare Administration, Public Health, or a related field (preferred).

- Bachelor's degree in Healthcare Administration, Public Health, or a related field with a minimum of 7 years of experience in healthcare quality and risk management, with experience in chronic care management (or a Master's degree with 5 years of experience).

- Certified in healthcare quality improvement (e.g., CPHQ, Six Sigma) or a related field (strongly preferred).

- Registered Nurse (BSN)

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee 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 employee is regularly required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is occasionally required to sit and stoop, bend, or kneel. The employee must occasionally lift and/or move up to 20 pounds.  Specific vision abilities required by this job include ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.