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Quality Assurance Manager for Healthcare Compliance

2 months ago

Belle Glade Florida, United States Health Care District of Palm Beach County Full time

Overview:
The Quality Assurance Manager is responsible for overseeing and directing all facets of quality control and enhancement within the healthcare facility.

This role encompasses the creation, execution, and assessment of quality enhancement programs to guarantee adherence to regulatory guidelines and optimal patient care results.

This position works closely with the administrative, clinical, and medical leadership teams at the Health Care District of Palm Beach County, fostering a culture of safety, evaluating care quality, and pinpointing opportunities and strategies for performance enhancement.

This role will also act as a liaison and expert for the facility concerning quality control and compliance with established standards and regulatory bodies.


Key Responsibilities:
Lead the formulation and implementation of quality enhancement projects and initiatives. Analyze performance data to discover areas needing improvement and apply evidence-based methods to elevate patient outcomes. Assess the success of implemented quality initiatives and modify strategies as required.

Conduct case reviews, chart audits, and data analysis to ensure compliance and initiate actions to enhance patient care.

Prepare and submit essential reports to regulatory authorities promptly.


Ensure that hospital practices align with local, state, and federal regulations, including those set forth by accrediting organizations.


Provide strategic oversight for proactive and reactive patient safety measures, including root cause analyses and failure mode effects analyses.


Collaborate with the Risk Management Team on reporting, investigating, analyzing, and planning corrective actions for medical errors and near misses.

Establish and monitor adherence to quality-related policies, procedures, and standards.

Work with IT to develop quality improvement dashboards and analyze pertinent trends.

Prepare reports and presentations on quality performance and improvement initiatives for leadership and stakeholders.


Engage with multidisciplinary teams in monitoring, reporting, and enhancing activities related to clinical care, operations, healthcare quality/safety initiatives, accreditation, and regulatory compliance.

Coordinate the facility's accreditation activities, including leading teams and committees in compliance efforts. Provide educational sessions on standards and coordinate ongoing compliance reviews and corrective actions.

Participate in various committees and projects to facilitate adherence to regulatory requirements.

Maintain readiness for unannounced agency visits and engage in various regulatory agency surveys.

Stay informed on industry trends, best practices, and emerging technologies in quality assurance and healthcare delivery.

Coordinate the Patient Safety Culture Survey with leadership and analyze and trend results.


Emergency duties may be required, including but not limited to: working in special needs shelters, performing other emergency responsibilities responding to threats or disasters as necessary.

Joint Commission Readiness Job Functions

Lead initiatives related to accreditation surveys, including preparation, execution, and follow-up of survey activities.

Conduct regular readiness evaluations and mock surveys to identify areas for improvement and ensure ongoing compliance.

Develop and implement corrective action plans for any identified deficiencies or areas needing enhancement.

Explore opportunities for expanding and standardizing continual readiness initiatives.

Qualifications:

Education:
Bachelor's Degree in Nursing; a Master's Degree in a related field is preferred.

Experience:


A minimum of three (3) years of progressive administrative leadership experience in quality and patient safety initiatives, demonstrating proficiency in designing and implementing performance improvement activities in a healthcare environment, including effective application of continuous quality improvement and patient safety principles.

Strong knowledge of regulatory requirements, accreditation standards (e.g., Joint Commission, CMS), and quality improvement methodologies (e.g., Lean, Six Sigma).

Certification:
Certification in Healthcare Quality is preferred (CPHQ). Lean Six Sigma certification is a plus.

Licensure:
Florida State License as a Registered Nurse. Valid Florida Driver's License.

Training:
Leadership and healthcare management training is preferred.

The Health Care District of Palm Beach County is proud to be an Equal Opportunity Employer and Drug-Free Workplace.

We embrace diversity and do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.