Quality and Safety Oversight Specialist III, Health Plan and Hospital, Non RN

1 month ago

Fresno, United States Kaiser Permanente Full time
Job Summary:
In addition to the responsibilities listed above, this position is also responsible for maintaining quality improvement systems, escalating issues as necessary; ensuring that the organization meets the standards established by regulatory agencies and accreditation organizations and meets public expectations with minimal guidance; validating the integrity of systems related to the selection, credentialing and competence of physicians and other health care practitioners; utilizing systems for granting or terminating clinical privileges, professional staff or medical staff or clinical staff membership, proctoring and continuing education with general guidance; leveraging standardized and established processes for review and approval of medical staff or provider staff Bylaws, Rules and Regulations and amendments; and monitoring oversight systems of all contracted entities including but not limited to the Permanente Medical Groups.
Essential Responsibilities:
  • Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome.
  • Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team.
  • Applies expertise for clinical quality improvement processes and regulations within assigned area practitioners and Quality Specialists by: maintaining awareness of current internal policies and relevant external regulations; participating on committees, projects to provide guidance and general recommendations on the enforcement, development of policies or procedures of regulations and auditing processes; leveraging collaborative, results oriented partnerships with practitioners across clinical and administrative roles to ensure compliance with regulations and improve patient safety, reporting accuracy, and health outcomes; and preparing materials for educational programs to raise awareness for regulation requirement, internal concerns, and system/database usage.
  • Facilitates quality of care complaints and the review process by: making recommendations based on available evidence and assessing if the quality of care complaint can be substantiated; preparing and reviewing all documentation, records, chart reviews, staffing reviews, and the information requested; and following up with the appropriate individuals/teams to ensure the quality of care concern is referred to the right team and monitoring any additional updates related to the specific concern and taking any follow-up action needed.
  • Assists with infection prevention and control programs to improve employee and patient safety by: assisting with epidemiological research as a part of prevention and surveillance, and outbreak management as requested; and adhering to outbreak protocols and assisting in all outbreak containment efforts within the area of focus.
  • Conducts risk management efforts by: assisting with the development of corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials, patient satisfaction surveys, and auditing surveys; conducting root cause analysis, failure mode and effect analysis, and other assessments in response to near misses and good catches in order to identify areas of improvement; utilizing health outcome analysis to continuously monitor oversight effectiveness; and assisting with escalating high-risk issues and trends to appropriate entity for resolutions.
  • Assists with patient safety and satisfaction programs and initiatives by: identifying safety hazards, accidents, incidents, threats, and significant events promptly and following up accordingly; and assisting in the delivery of patient outcomes to improve or implement safer patient practices and services and seamless transition of care.
  • Assists in the development of new clinical quality improvement and quality improvement programs by: facilitating meetings with practicians, teams, and departments to gather information for the development of guidelines, metrics, and operational definitions of quality improvement through qualitative and quantitative program evaluation, ongoing monitoring of program performance, and peer/department review groups; developing an understanding and staying abreast of a variety of health concepts, regulatory requirements, and change management principles to develop programs which optimize clinical quality, safety, or health outcomes; and supporting the integration of continuous learning orientation into programs to assist with oversight, development, and improvement initiatives.
  • Assists in the collection and entry of data into systems, procedures, and forms to improve data management programs and utilizes data from internal and external sources to monitor and evaluate quality improvement initiatives by: conducting descriptive and inferential statistical analysis for routine quality improvement evaluations; gathering data from databases, vital statistics, hospital patient discharge data, claims, and other relevant health sources; and preparing reports (e.g., infection control research, utilization reviews, population health needs analysis, patient satisfaction) into specified formats.
  • Conducts regulatory audits and surveys by: assisting with onsite visits and evaluations and supporting the coordination with the relevant department as directed; preparing requested audit documentation, information, reports, and tools throughout the auditing process; and communicating and coordinating with the supervisor and relevant departments on the status of survey completion and any follow-up actions as required for auditing surveys.
  • Supports the evaluation of the cost effectiveness, practicality, appropriateness, and equal application of care to diverse patients by: prepari

  • Quality and Safety Oversight Specialist III, Health Plan and Hospital, Non RN

    2 months ago

    Fresno, United States Kaiser Permanente Full time

    Job Summary: In addition to the responsibilities listed above, this position is also responsible for maintaining quality improvement systems, escalating issues as necessary; ensuring that the organization meets the standards established by regulatory agencies and accreditation organizations and meets public expectations with minimal guidance; validating the...

  • Quality Oversight Engineer Rail

    1 week ago

    Fresno, United States PGH Wong Engineering Full time

    PGH Wong Engineering, Inc. has a proud and lengthy history of delivering innovative, challenging, and complex projects. PGH Wong was established in 1985 on its extraordinary foundation in systems engineering and is now a full-service engineering, architecture, construction management, and program/project management consulting firm for public and private...

  • Clinical Quality Assurance Specialist

    7 days ago

    Fresno, California, United States Incredible Health Full time

    OverviewIncredible Health is actively hiring a Clinical Quality Assurance Specialist in the Fresno, CA area. This role is a vital part of our healthcare team, ensuring the highest standards of patient care and safety.SalaryThe estimated salary for this position is $65,000 to $145,000 per year, depending on experience.Job DescriptionThis Clinical Quality...

  • Quality Assurance Nurse Specialist

    7 days ago

    Fresno, United States Incredible Health Full time

    Company Overview:Incredible Health is actively hiring and accepting applications for the position of Quality Assurance Nurse Specialist in the Fresno, CA area.Job Summary:This role requires a Registered Nurse with experience in audit, patient safety, or performance improvement to join our team and contribute to ensuring high-quality patient...

  • Medical Professional

    4 weeks ago

    Fresno, United States Incredible Health Full time

    Job Title: Registered Nurse - Quality AssuranceAbout the Role:Incredible Health is actively hiring Registered Nurses in Fresno, CA. As a Quality Assurance Specialist, you will be responsible for ensuring the highest standards of patient care and safety.Responsibilities:Conduct audits and assessments to identify areas for improvementDevelop and implement...

  • Senior Quality Assurance Specialist

    4 days ago

    Fresno, California, United States Foster Farms Full time

    Job OverviewFoster Farms is a leading poultry producer, committed to delivering high-quality products to consumers. We are seeking a Senior Quality Assurance Specialist to join our team in ensuring the highest standards of food safety and quality.Key ResponsibilitiesThe successful candidate will be responsible for overseeing and administering our Food Safety...

  • Food Safety and Quality Assurance Manager

    6 days ago

    Fresno, California, United States Vie Del Full time

    About Vie DelVie Del is a prominent manufacturer of grape concentrates, brandy, spirits, and wines. We are seeking highly skilled professionals to join our team. We offer an attractive salary package and an excellent benefits program in a supportive work environment.Job OverviewThe Food Safety and Quality Assurance Manager will be responsible for developing,...

  • Mental Health Professional III

    4 days ago

    Fresno, California, United States Turning Point of Central California Full time

    About the JobJoin Turning Point of Central California, Inc. in our mission to transform lives across California.Job SummaryWe are seeking a highly skilled Mental Health Professional III to provide therapeutic services to clients with severe mental illness and dual diagnosis individuals. The ideal candidate will possess strong clinical skills, excellent...

  • Registered Nurse

    2 months ago

    Fresno, United States Incredible Health Full time

    Hospitals on Incredible Health are actively hiring and accepting applications in the Fresno, CA area for the following position: Registered Nurse - Quality Assurance. Nurses with experience in any of the following areas are strongly encouraged to apply: Audit, Patient Safety, or Performance Improvement. Shift(s) available: day shift, night shift, and mid...

  • Maternal Child Health Nurse Specialist

    6 days ago

    Fresno, California, United States St Agnes Medical Ctr Full time

    Company OverviewWe are seeking a skilled Maternal Child Health Nurse Specialist to join our team at St Agnes Medical Center. Our organization is dedicated to providing high-quality patient care and services.Job SummaryThis position involves working as an L&D RN in a dynamic healthcare environment, collaborating with a multidisciplinary team to deliver...

  • Compliance Assurance Specialist

    1 week ago

    Fresno, California, United States MSCCN Full time

    About MSCCNMSCCN is a major producer of concentrates from grapes and other fruits, brandy, spirits, and wines. We offer a competitive salary and excellent benefit package in an employee-friendly and rewarding environment.SummaryThe Compliance Assurance Specialist is responsible for ensuring compliance with all relevant regulations and standards. This...

  • Travel Nurse RN Specialist

    4 days ago

    Fresno, California, United States Health Carousel Travel Nursing and Allied Health Full time

    Job Overview">We are seeking a highly skilled and experienced Travel PACU RN to join our team in Fresno, CA.">About the Role">This 13-week assignment offers a unique opportunity to work with Health Carousel Nursing and Allied Health, providing high-quality patient care in a dynamic environment.">Key Responsibilities">">Provide expert nursing care to patients...

  • Consultant III

    7 days ago

    Fresno, United States Kaiser Permanente Full time

    The Consultant role will be a primary support role to the Area Portfolio Leader, and local Portfolio Management Office, responsible for developing performance improvement capabilities and daily management system structure in the Fresno service area. This includes assisting with goal deployment and tracking, training development and deployment, management...

  • Medical Traveler RN Opportunity at Fresno Heart

    6 days ago

    Fresno, California, United States Fresno Heart & Surgical Hospital Full time

    We are seeking a skilled Medical Traveler RN to join our team at Fresno Heart & Surgical Hospital. This is an exciting opportunity for a dedicated and experienced Registered Nurse to provide high-quality patient care in a fast-paced environment.About the PositionThis Medical Traveler RN position offers a competitive salary of $85,000 - $120,000 per year,...

  • Clinical Nurse Specialist RN

    4 days ago

    Fresno, California, United States Fresno Heart & Surgical Hospital Full time

    About Fresno Heart & Surgical HospitalWe are a leading medical institution dedicated to providing exceptional patient care and advancing the field of cardiovascular health.Estimated Salary: $120,000 - $180,000 per yearJob DescriptionWe are seeking a highly skilled Clinical Nurse Specialist RN for our Cardiovascular Intensive Care Unit (CVICU) at Fresno Heart...

  • Traveling RN CVOR Healthcare Specialist

    1 day ago

    Fresno, California, United States Ardor Health Solutions Full time

    Job OverviewArdor Health Solutions is a leading medical staffing firm seeking a skilled Traveling RN CVOR Healthcare Specialist for a travel nursing position in Fresno, California.This 13-week assignment offers a unique opportunity to work in a hospital setting and provide high-quality patient care while exploring the city of Fresno.Estimated SalaryWe...

  • Charge RN, Labor and Delivery

    4 weeks ago

    Fresno, United States Community Health System Full time

    Charge RN, Labor and Delivery Requisition ID 8 Category Registered Nurse Shift Type Part-Time Shift 12 Hour Shift Schedule Nights Additional Shift Details Looking for RNs with Labor and Delivery experience Facility Community Regional Medical Center (CRMC) Location US-CA-Fresno Posted Date 10/29/2024 Min USD $52.44/Hr. Max USD $68.17/Hr. Overview All...

  • Acute Care Specialist

    6 days ago

    Fresno, California, United States DaVita Full time

    About the RoleWe are seeking a dedicated and compassionate Acute Care Specialist to join our team at DaVita. This role is responsible for delivering high-quality care to patients with end-stage renal failure or chronic kidney disease in a hospital setting.ResponsibilitiesPrioritize patient needs and provide individualized care plans to ensure optimal health...

  • Health Coach Specialist

    6 days ago

    Fresno, California, United States Trinity Health Full time

    Company OverviewTrinity Health, a leading not-for-profit Catholic healthcare system, is committed to delivering high-quality patient care and promoting wellness in our communities. Our Mission and Core Values guide everything we do, from hiring talented professionals like you to providing accessible and equitable care for all.Salary Range$27.72 - $38.80 per...

  • Travel Nurse RN Labor and Delivery Specialist

    1 day ago

    Fresno, California, United States Trinity Health FirstChoice Full time

    About the JobWe are seeking a highly skilled Travel Nurse RN Labor and Delivery Specialist to join our team at Trinity Health FirstChoice. This is an exciting opportunity for nurses to experience a variety of practice settings while traveling within their local region or nationally.Job SummaryThis 13-week travel nursing assignment in Fresno, California...