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Quality Manager

1 month ago

Altoona, United States tapwage Full time

Job Details

Description

Job Summary:

The Quality Manager is responsible for leading and overseeing all aspects of quality management and performance improvement initiatives at OakLeaf Surgical. This position plays a crucial role in ensuring the delivery of high-quality patient care, compliance with regulatory standards, and continuous improvement of processes and outcomes.

Essential Job Functions

Strategic Functions:

- Develop, implement, and manage a comprehensive quality management program tailored to the unique needs of OakLeaf Surgical.
- Collaborate with departmental leaders to establish and maintain quality indicators, benchmarks, and performance metrics.
- Facilitate performance improvement initiatives to enhance patient outcomes, patient safety, and overall efficiency.
- Implement benchmarking activities to compare the hospital’s performance with industry standards.

Operational Functions:

- Monitor and evaluate clinical and non-clinical processes to identify opportunities for improvement.
- Lead efforts to prepare for and participate in accreditation surveys, certification surveys, and regulatory audits.
- Conduct root cause analyses, high priority reviews, and proactive risk assessments.
- Build relationships with providers to ensure patient safety and regulatory compliance are followed.
- Implement corrective action plans to address identified issues.
- Utilize data analytics to assess and report on key performance indicators, trends, and areas for improvement.
- Develop and present regular reports to hospital leadership, medical staff, and relevant committees.
- Lead the education department to design and deliver training programs related to quality improvement, patient safety, and regulatory compliance.
- Lead risk management to identify, assess, and mitigate potential risks to patient safety and quality of care.
- Participate in the development and implementation of risk reduction strategies.
- Foster collaboration and communication among various departments, medical staff, and other stakeholders to achieve quality improvement goals.
- Chair and participate in Performance Improvement and Safety Committee.
- Chair and participate in Administrative Policy Committee.
- Chair and participate in Health Equity Committee.
- Participate in the following committees: Emergency Management, Total Joint Certification, Educational Council, Antibiotic Stewardship, Utilization Management, and Water Management committees.
- Oversee Infection Control and Employee Health program to ensure compliance with regulatory bodies.
- Serves as a member of the Internal Review Board and the Medical Executive Committee
- Develops and implements solutions to meet the ongoing documentation requirements of the hospital while maintaining patient safety.
- Stay informed about industry best practices and trends in quality management for surgical hospitals.
- Completes annual review of assigned policies.

Leadership Functions:

- Direct, administer and manage the operations of assigned functions.
- Assign tasks and review work of direct reports.
- Monitor direct reports adherence to Hospital protocols and procedures.
- Provide performance management directive including annual evaluations, coaching, development and corrective action.
- Engage in staff development through education and training.
- Ensure direct reports have adequate equipment and resources to carry out high quality patient care.
- Ability to perform as administrator on-call rotation.
- Ability to attend meetings outside of normal business hours as needed.

Other duties as assigned.

Knowledge Skills and Abilities:

- Ability to take control of situations and dictate subordinate activities in a responsible manner.
- Ability to instruct and train in policies and procedures.
- Ability to prepare performance evaluations and make recommendations regarding unsatisfactory employees.
- Ability to assign work, add or delete, plan work and establish priorities.
- Ability to comprehend, retain and apply the requirements of any governmental or regulatory body.
- Ability to exhibit strong communication, presentation and listening skills to ensure facility-wide collaboration and coordination.
- Ability to build consensus and commitment among various stakeholders.
- Ability to understand and address complex issues in the critical areas of healthcare, including but not limited to regulatory/legislative changes and physician partnerships.
- Ability to maintain high ethical standards, integrity, and professionalism consistent with OakLeaf’s Customer Service Standards
- Ability to relate and work effectively with others.

Equipment Knowledge Required:

- Ability to operate various types of equipment – standard office equipment, computers, and intermediate knowledge of Microsoft Office and other programs as assigned.
- Ability to use Electronic Medical Record system.
- Other equipment could be required.

Reasoning Ability:

- Ability to define problems and deal with a variety of situations.
- Ability to make decisions independently with strong decision-making capability.
- Ability to think quickly, maintain self-control, and adapt to stressful situations.
- Ability to use a fact-based approach to assessing and designing solutions.

Language Skills:

- Ability to exhibit excellent communication, presentation, and listening skills.
- Ability to communicate effectively with other members of the staff, physicians, patients, and corporate partner.
- Ability to develop, interpret and implement local policies and procedures; general correspondence; and Federal, State, and local regulations.
- Ability to communicate in English in both written and verbal format.

Mathematical Skills:

Ability to perform intermediate mathematical calculations.

Qualifications:

- Demonstrates eligibility for employment in the U.S.
- Bachelor’s degree in Nursing required.
- Master’s degree in business, healthcare administration is preferred.
- Five (5) or more years of healthcare experience required.
- Registered Nurse licensure in the state of Wisconsin required.
- Leadership experience preferred.
- Intermediate experience in Microsoft Office required.
- Certified Professional in Healthcare Quality (CPHQ) required within 24 months of hire date.

Benefits:

- Comprehensive health, dental, and vision insurance
- Health Savings Account with an employer contribution
- Company paid life insurance
- Free meals
- PTO
- 401(k) retirement plan with 4% company match
- Tuition reimbursement
- Wellness reimbursement