Quality and Safety Oversight Specialist Ii, Health

2 months ago

Vallejo, United States Kaiser Permanente Full time

**Job Summary**:
In addition to the responsibilities listed above, this position is also responsible for learning about quality improvement systems and organizational accreditation and credentialing; ensuring that the organization meets the standards established by regulatory agencies and accreditation organizations and meets public expectations following clear guidance; documenting and monitoring the integrity of systems related to the selection, credentialing and competence of physicians and other health care practitioners as directed; learning about systems for granting or terminating clinical privileges, professional staff or medical staff or clinical staff membership, proctoring and continuing education; leveraging standardized and established processes for review and approval of medical staff or provider staff Bylaws, Rules and Regulations and amendments; and assisting with monitoring oversight systems of all contracted entities including but not limited to the Permanente Medical Groups.

**Essential Responsibilities**:

- Pursues effective relationships with others by sharing resources, information, and knowledge with coworkers and members. Listens to, addresses, and seeks performance feedback. Pursues self-development; acknowledges strengths and weaknesses based on career goals and takes appropriate development action to leverage / improve them. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work. Assesses and responds to the needs of others to support a business outcome.
- Develops expertise for clinical quality improvement processes and regulations within assigned area by: learning and developing knowledge of current internal policies and relevant external regulations; supporting committees, projects to provide guidance on the enforcement, development of policies or procedures of regulations and auditing processes as directed; supporting 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.
- Supports the quality review process for quality of care complaints and reviews, with guidance from senior team members by: preparing materials and reports for grievance meetings, cases, reviews, referrals, or other mechanisms as requested; preparing documentation, records, and information as directed; and monitoring cases, quality care incidents, and near misses according to established protocols as requested.
- Assists with infection prevention and control programs to improve employee and patient safety with guidance from senior team members by: assisting with epidemiological research as a part of prevention, surveillance, and outbreak management as requested; and adhering to outbreak protocols and assisting in all outbreak containment efforts within the area of focus.
- Supports oversight and 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 as directed; 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 as requested; assisting with the utilization of health outcome analysis to continuously monitor oversight effectiveness; and assisting with escalating high and risk issues and trends to appropriate entity for resolutions.
- Assists with patient safety and satisfaction programs and initiatives by: reporting safety hazards, accidents, incidents, threats, and significant events promptly; 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 programs by: facilitating meetings with practitioners, teams, and departments to gather information for the development of guidelines, metrics, and operational definitions of quality improvement through qualitative and quantitative program evaluation and peer/department review groups; developing an understanding 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 desc

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