Director Quality

2 weeks ago

Olympia, United States Providence St. Joseph Health Full time

Providence St. Joseph Health

Director Quality (RN)

Olympia ,

Washington

Apply Now

DescriptionTHE ROLEThis Director provides vision and leadership throughout the organization and for continuous improvement of clinical and service quality outcomes; designs, implements and maintains systems ensuring integration of quality support across the organization, improvement of health outcomes; integrates and promotes patient safety and regulatory compliance; and optimizes risk prevention. The Director is also responsible for all documentation improvement related functions for all facilities within Southwest Washington, including auditing; training; quality and productivity; policies and procedures; and compliance with all government and regulatory bodies' guidelines and requirements. The Director implements and maintains SWR needed infrastructure to support, maintain, and achieve overall documentation improvement excellence and compliance in order to ensure accurate statistics and appropriate reimbursement. Responsibilities of this position also include meeting the requirements of The Joint Commission Standards, NCQA for the CVO and other applicable federal, state and local regulatory and/or accrediting agencies.ESSENTIAL FUNCTIONSLeads Clinical Documentation Integrity Program in SWR, (PSPH, PCH and PMG) including auditing, training, quality and productivity, policies and procedures, and compliance with government and regulatory body guidelines and requirements.Maintains knowledge of all federal, state, coding and documentation guidelines and communicates changes to all clinical documentation Integrity staff.Oversees, interviews, hires, trains, and evaluates all caregivers; counsels' caregivers regarding employment and performance management in accordance with Human Resources policies; ensures competency of all staff by conducting on-going regular reviews and skills assessments and provides action plans and timely, providing constructive feedback as needed.Maintains knowledge of all federal, state, coding and documentation guidelines and communicates changes to all staff.Generates and analyzes reports to identify opportunities for continuous improvement by ministries; provides feedback, develops and implements action plans when appropriate.Develops and monitors implementation of ministry specific goals/objectives and performance improvement processes.Develops policies and procedures for the documentation integrity program and defines workflows for process improvement enhancement.Supports physician champions and service line directors to provide physician education regarding documentation improvement and any applicable updates in regulatory guidelines in conjunction with coding pillar and quality director.Develops and maintains budget requirements and ensures compliance.Oversees the security and legal protection of the electronic reporting and database system for access, dissemination of data, tracking and analysis of occurrences, loss trends and other risk management statistical data and benchmarking where appropriate.Provides direction to department and facility leadership in planning of a systematic, organization-wide approach to continuous regulatory readiness.Oversees the education of staff, including providers, on changes in billing guidelines for third party payers, Medicare, and Medicaid Develop audit tools, a scoring system, and the billing compliance.QUALIFICATIONSMaster's Degree in NursingUpon hire: Washington Registered Nurse License (Vendor Managed)Upon hire: Current CCDS certificate (preferred)5 years of Clinical nursing experience, preferably in Medical/Surgical, Critical Care, Intensive Care, or the Emergency Department2 years of Leadership experience in a Clinical Documentation Improvement ProgramCDI Subject Matter ExpertKnowledge of Medicare Part A and familiar with Medicare Part BKnowledge of disease pathophysio

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