Job Description

Job Summary:

This position involves consulting with the Board of Directors to provide strategic oversight of systems ensuring quality care and services across the continuum of care. Responsibilities include resolving issues in quality improvement systems, aligning with regulatory standards, championing best practices for credentialing and clinical privileges, and serving as a liaison for contracted entities. The role also entails leading peer review processes, developing strategic plans, and ensuring hospital or health system performance.

Essential Responsibilities:

1. Develops talent, fosters collaboration, and manages performance to meet organizational goals.
2. Oversees departmental operations, translating strategy into actionable plans and ensuring service quality.
3. Acts as a subject matter expert on clinical quality improvement, advising on policies, regulations, and compliance.
4. Manages the quality of care complaints and review processes, reporting trends and advising on strategic directions.
5. Leads risk management efforts, establishing standards for corrective actions and health outcome analyses.
6. Develops and sustains clinical quality improvement programs, collaborating with stakeholders and ensuring program sustainability.
7. Improves data management systems, utilizing data for performance monitoring and strategy development.
8. Prepares for regulatory audits, maintaining compliance and survey readiness.
9. Evaluates the cost-effectiveness and appropriateness of medical care, ensuring standards are met and patient needs are addressed.

Minimum Qualifications:

• At least 2 years managing operational or project budgets.
• At least 7 years in a leadership role, with or without direct reports.
• At least 5 years working with databases and spreadsheets.
• At least 4 years delivering training programs.
• At least 7 years in clinical or healthcare administration, or a related field.
• Bachelor’s degree in Business Administration, Healthcare Administration, Nursing, Public Health, or related field, plus 7 years of healthcare experience, or 10 years of healthcare experience without a degree.

• Registered Nurse License (California).

• Professional Healthcare Quality Certificate within 24 months of hire.

Additional Requirements:

• Knowledge, Skills, and Abilities include negotiation, process improvement, risk management, compliance, data analytics, community health, coding, consulting, relationship management, delegation, project management, and quality standards.

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