Director Of Quality Management Resume Samples

Description :

1. Coordinates preparation for and the sequence of activities involved in surveys/audits (including DHS, DOH, OMHSAS, Joint Commission, MCOs).
2. Provides support and guidance in the development of corrective action plans as the result of site reviews.
3. Maintains Joint Commission accreditation and coordinates efforts to adhere to compliance standards.
4. Reports sentinel events and appropriate root cause analyses as needed.
5. Initiates tracers/chart compliance reviews as needed for quality assurance.
6. Serves as Center liaison with the Corporate Clinical / QI team for outcomes.
7. Coordinates and chairs the quarterly Performance Improvement Coordinating Council meeting in conjunction with the Executive Director.
8. Coordinates the Center's procedure process with Center Leadership and ensures timely review and approval of procedures.
9. Reviews procedures to ensure they meet regulatory requirements.

Experience

2-5 Years

Level

Junior

Education

Bachelor's

Description :

1. Supervises Protection from Harm Initiatives.
2. Monitors and oversees protection from harm databases and ensures monthly and annual trending of data reports.
3. Serves as a member of the Advisory Board for Operations.
4. Maintains compliance with all regulatory entities to include Medicaid and TN Care Completes and ensure application for all new licenses and applications for all new services within AR and GA Operations.
5. Participates in quality management reviews and supported living homes and office sites.
6. Develops action plans for all state, licensure, and other regular entity reports.
7. Tracks and trends announced and unannounced internal QA visits and develops action plans for these visits and tracks completed actions.
8. Assists with completion of Annual Assessment reports.

Experience

10+ Years

Level

Senior

Education

Masters

Description :

1. Manages, motivates and mentors team members regularly to help them set, measure, and achieve developmental and performance goals, correcting performance where necessary
2. Oversees the design, development, and maintenance of manual test scripts, including release candidate test cases and customer workflow tests, while working with automation engineers and software developers to automate manual scripts
3. Monitors quality across all products through data and metrics in collaboration with other stakeholders outside of product (support, training, account management, etc.)
4. Defines process specifically to reduce and prevent escaped defects from making their way to production
5. Ensures that all quality assurance team members are trained in process, product, and customer workflows.
6. Works with Product and Development counterparts to foster a collaborative, team-focused environment
7. Interviews, hires and develops high-performing team members
8. Gathers, understands, maintains, and communicates customer workflows
9. Collaborates with Development to optimize the use of test automation in the overall testing strategy

Experience

2-5 Years

Level

Junior

Education

Bachelor's

Description :

1. Coordinates preparation of reports for the Quality Council.
2. Prepares of all Core Measures for the Quality Council.
3. Supervises of reviews for all Hospital-Wide Measures.
4. Coordinates findings and corrective actions with Risk Management.
5. Maintains data for all ongoing studies and Performance Improvement initiatives.
6. Represents Quality Management on all Hospital Committees.
7. Coordinates Joint Commission readiness across departments.

Experience

2-5 Years

Level

Junior

Education

Masters

Description :

1. Directs daily activities and efforts for clinical team of RNs and MDs, oversee credentialing team and plan practitioners, as well as, leads performance improvement programs.
2. Creates and executes strategies enhancing physician performance establishing standards and formalized requirements.
3. Interprets and communicates clinical guidelines to internal teams and network practitioners.
4. Performs annual CAHPS and QI Program Analysis identifying strengths and areas in need of improvement and assist in the development of solutions.
5. Leads provider profiling process monitoring physician care, participate in administration of Physician Incentive Program, and lead Potential Quality Issues (PQI) process.
6. Drives accuracy and efficiency handling State Medicaid, STAR/CHIP audits and data reporting.
7. Performs analysis of EQRO data and report data and collaborated closely with cross-functional teams leading achievement of quality requirements.
8. Successfully achieved interim NCQA Accreditation with first full survey scheduled through strategic project management leadership.

Experience

5-7 Years

Level

Executive

Education

Master's

Description :

1. Responsible for STARs, HEDIS and Risk strategy create and drive implementation and engagement through organizational influence for maximizing rating above 4 STARs.
2. Led development of yearly and long term STARs, HEDIS, and Risk strategy.
3. Responsible for Real time ongoing measurement of outcomes, driving analysis/monitoring STARs related activities across the organization.
4. Collected data, analyzed, and reported all aspects of STARs requirements as CMS changes occur to assure continuous course corrections are made and documented.
5. Ensured MSO accountability and engagement oversight supported the improvement of STARs performance.
6. Identified process improvement opportunities.
7. Monitored Risk and Revenue optimization to identify opportunities such as providing provider training for appropriate coding.
8. Adviced Executive leadership on outcomes and opportunities to improve STARs results.
9. Ensured compliance with HEDIS technical specifications, policies, operating procedures, and ongoing goals in compliance with internal and external guidelines.

Experience

7-10 Years

Level

Management

Education

Bachelor's

Description :

1. Directed report to Chief Executive Officer.
2. Oversaw and managed the hospital's Quality, Risk, Infection Control, and Employee Health programs.
3. Maintained a constant Survey Readiness for the hospital.
4. Organized and led the quarterly meetings, OIC, MEC, and Governing Board for the hospital.
5. Improved JCAHO, COLA, and CMS surveys from prior results.
6. Implemented and monitored the Ambassador Program as a Customer Service initiative.
7. Led the hospital through JCAHO and COLA surveys with improved results.
8. Successfully steered hospital through the first CMS Validation Survey and two DHH visits.

Experience

2-5 Years

Level

Junior

Education

Bachelor's

Description :

1. Directed the hospital-wide performance improvement projects in order to promote safe, efficient and quality care through the implementation of evidence-based best practices.
2. Completed data analyses, evaluating process improvement strategies/interventions based on outcome measures.
3. Identified and communicated operational needs and potential failure modes to administration/governing body via failure mode effect analyses and other quality management tools/strategies.
4. Facilitated root cause analyses following adverse events for all serious and or near miss events that throughout the hospital.
5. Coordinated and supported management team/physicians with clinical/operation modifications necessary in order to meet hospital regulatory and accreditation standards/requirements e.g.
6. Department of Health, Center for Medicare/Medicaid Conditions of Participation, Joint Commission, etc.
7. Ensured that formal grievances/complaints are investigated in a timely manner and that patients are provided a written response explaining the summation of the investigation and the actions that were taken.
8. Managed patient safety initiatives in order to identify and reduce risk of harm/undesirable events throughout the hospital.
9. Managed monetary incentive programs ensuring that specified measures are addressed and appropriate actions are taken in order to ensure compliance and meet expectations e.g.

Experience

5-7 Years

Level

Executive

Education

Masters

Description :

1. Responsible for the coordination, development and evaluation of all outcome activities for Risk management, Quality Improvement, Survey Readiness, Infection Control, Employee Health, Staff Education and Patient/Family Satisfaction Survey.
2. Responsible for communicating results and participation in development of strategies for improvement as a member of the hospital management team.
3. Coordinates all activities to assure that the facility maintains accreditation, certification and licensure with The Joint Commission on Hospital Accreditation, Mississippi Health Department and Centers for Medicare and Medicaid.
4. Provides education and training to department managers on roles and responsibilities in the accreditation/certification process.
5. Implements and evaluates corporate quality plan and reports to the Governing Board annually.
6. Organizes monthly interdisciplinary Quality Assurance Performance Improvement meetings, Periodic Performance Review and Root Cause Analysis.
7. Receives and reviews the quality improvement reports and report's findings to the Organization Improvement Committee, Administration, Medical Executive Committee and the Governing Body.
8. Investigates patient and family concerns and brought to the attention of administration Conduct monthly unit inspections for infection control and environment of care Assists department managers in the implementation of corporate policies and procedures.
9. Assists Medical Director with development and implementation of medical staff improvement activities.

Experience

10+ Years

Level

Senior

Education

Bachelor's

Description :

1. Promotes quality achievement and performance improvement throughout the organization.
2. Organizes and promotes quality improvement efforts in clinical, financial, and administrative operations of the organization.
3. Develops and performs internal audits and monitoring systems.
4. Analyzes audit results and write technical reports.
5. Recommends and assists in the implementation of quality controls and corrective action.
6. Collaborates with staff of different disciplines and lead the group to plan, formulate and agree to comprehensive quality procedures using a consensus model.
7. Monitors performance through data analysis and outcomes measurement and produce statistical reports.
8. Collates and analyzes performance data against defined parameters.

Experience

0-2 Years

Level

Entry Level

Education

Masters