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Quality and Risk Management Specialist

2 months ago

Huntsville, Alabama, United States American Health Partners Full time

The Quality and Risk Management Specialist will spearhead the development and execution of quality assurance and risk mitigation strategies. This role is pivotal in monitoring patient outcomes and assessing risks throughout the treatment process, while also conducting thorough reviews and audits of risk management practices within the organization.

Furthermore, the Specialist will oversee the organization, direction, and supervision of activities related to the collection, evaluation, processing, and archiving of medical documentation.


KEY RESPONSIBILITIES:

To excel in this position, the individual must effectively perform each essential duty, with or without reasonable accommodation.

  • Oversee performance metrics in critical areas such as clinical outcomes, quality assurance, and service excellence.
  • Design and implement the organization's risk management framework in alignment with its mission and strategic objectives, ensuring compliance with relevant federal and state regulations and accreditation standards.
  • Provide education and training to leadership and staff regarding risk management protocols and their respective roles in these initiatives.
  • Guide and support departments in formulating effective risk management strategies.
  • Gather, analyze, and maintain data related to identified risk factors.
  • Conduct investigations to determine root causes; identify patterns and implement corrective measures as necessary.
  • Actively engage in or facilitate committees focused on risk management, safety, and quality enhancement.
  • Perform random audits of patient records to identify risk areas, including but not limited to admission/readmission audits.
  • Assist in the intake process for skilled residents.
  • Ensure compliance with documentation standards.
  • Coordinate physician visit schedules.
  • Handle incoming calls and direct them to the appropriate personnel.
  • Support daily operational activities as required.
  • Identify and rectify inaccuracies in documentation according to established protocols.
  • Assist in charge nurse responsibilities as assigned.
  • May participate in an on-call rotation as needed.
  • Other responsibilities as assigned.

JOB REQUIREMENTS:

  • Maintain confidentiality of records and sensitive information related to residents, staff, and the facility.
  • Adhere to established safety protocols and isolation procedures.
  • Foster a positive atmosphere of warmth and concern for residents' personal and healthcare needs.
  • Recognize and respond to resident emergencies promptly.
  • Contribute to an environment that promotes mutual respect and open communication across all disciplines.
  • Encourage teamwork and enthusiasm.
  • Serve key stakeholders, including patients, colleagues, physicians, and the community, with a positive attitude.
  • Approach problem-solving in a systematic manner to achieve desired outcomes.
  • Comply with all policies regarding confidentiality and anonymity of patient records.
  • Interact in a friendly, respectful, and professional manner with patients, families, and staff.
  • Promote and ensure a drug-free and violence-free workplace.
  • Maintain a consistent work schedule.
  • Complete all required training successfully.
  • Effectively manage multiple priorities.
  • Possess reliable transportation.
  • Exhibit regular and dependable attendance.

TECHNICAL SKILLS:

  • Proficient in various operating systems.
  • Familiar with standard office equipment.
  • Skilled in Microsoft Office applications.
  • Experience with desktop, laptop, and/or tablet devices.
  • Knowledge of personal protective equipment (PPE) usage.
  • Proficient with standard medical equipment.

QUALIFICATIONS:

Skills:
  • Expertise in data collection, analysis, and interpretation.
  • Familiarity with federal and state regulations and accreditation standards.
  • Strong leadership capabilities.
  • Ability to educate and mentor others on risk management topics.
  • Commitment to process improvement and fostering a culture of safety.
  • Capability to lead teams through complex issues.
  • Understanding of legal aspects of clinical practice and professional standards.

Experience:
  • Significant supervisory experience in a geriatric care setting.
  • A minimum of one year of experience in risk management, quality improvement, health information management, healthcare administration, patient care, or business management is preferred.
  • Experience in geriatric care is highly desirable.

EDUCATION AND CERTIFICATION:
  • Graduate from an accredited nursing program with a registered nursing degree.
  • Current RN license in the state of practice.
  • CPR certification.
  • Ongoing education to maintain licensure and certification.

SUPERVISORY RESPONSIBILITIES:
  • No direct supervisory responsibilities.
  • May require occasional guidance from management in exceptional circumstances.

WORKING ENVIRONMENT:
  • Ability to lift up to 40 pounds.
  • Risk of exposure to bloodborne pathogens and other infectious diseases.
  • Work is typically conducted in a standard long-term care facility, which is well-lit and climate-controlled.
  • Frequent exposure to above-average conversational noise.
  • Flexibility in work hours may be required, including unscheduled overtime or weekend shifts.
  • Must be proficient in spoken and written English.
  • Travel may be necessary.


The physical demands outlined here are representative of those required for an employee to successfully perform the essential functions of this role. Reasonable accommodations may be made to enable individuals with disabilities to fulfill these essential functions.


EEO:
This employer participates in E-Verify.