Director Quality

2 weeks ago

Olympia, United States Providence Health & Service Full time
Job Description

THE ROLE

This 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 FUNCTIONS
  • Leads 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.
QUALIFICATIONS
  • Master's Degree in Nursing
  • Upon 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 Department
  • 2 years of Leadership experience in a Clinical Documentation Improvement Program
  • CDI Subject Matter Expert
  • Knowledge of Medicare Part A and familiar with Medicare Part B
  • Knowledge of disease pathophysiology and drug utilization
  • Knowledge of MS-DRG classification and reimbursement structures
  • PC/Systems literacy, including the Internet and MS office skills.
  • Ability to apply coding conventions, official guidelines, and Coding Clinic advice to health record documentation.
  • Management of multiple priorities - effective time management skills
  • Leadership and organizational skills along with critical, deductive reasoning, and problem solving skills.
  • Effective written and verbal communication skills, including report writing and oral presentation skills.
  • Capacity to work independently in a virtual office setting, or in a facility setting if required to travel for assignment.
  • Understanding and ability to communicate documentation strategies.
  • Capable of performing quality assessment/analysis
  • Overall knowledge and ability to drive operational metrics.
  • Overall knowledge of the flow of the revenue cycle
  • Detail oriented and with strong analytical skills.
  • Ability to assess, coach, train and develop talent.
  • Ability to motivate and maintain effective working relationships with staff and all stakeholders.
  • Demonstrates strength in both performance management and leadership development.
  • Manage change while minimizing interruption at an operational and service level.


About Us

At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Check out our benefits page for more information about our Benefits and Rewards.

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