Clinical Process Improvement Specialist

7 days ago

Queens, New York, United States LiveOnNY Inc Full time

Job Summary

LiveOnNY Inc is seeking a highly skilled Clinical Process Improvement Specialist to join our team. As a key member of our Clinical and Recovery Services department, you will be responsible for ensuring accurate and timely policy- and standards-compliant documentation, investigation, and corrective actions of Occurrences.

Key Responsibilities

  • Coordinate and schedule Clinical Operations occurrence processes with organizational leadership, including occurrences identified in Clinical Services, Organ Allocation, Organ Recovery, Tissue Services, Donor Center, and Referral Triage.
  • Conduct Investigations, Interviews, Root Cause Analyses, and Corrective Actions as indicated, in collaboration with the Director and Manager to ensure compliance with LiveOnNY policies, regulations, and standards.
  • Review submitted Clinical and Recovery Services' Occurrences for policy- and standards-appropriate throughput in LiveOnNY's Quality Management System, including reviewing assignments of categorization and severity level by the Process Transformation and Innovation Specialist, alongside identified key stakeholders.
  • Identify appropriate Occurrences for Root Cause Analysis. Organize and conduct Root Cause Analysis processes, including identifying necessary involvement of departmental leadership and ensuring accurate and timely documentation and performance of investigations, corrective actions, and quality review prior to effectiveness assessments by the Department of Process Transformation and Innovation.
  • Ensure accurate and timely implementation and documentation of Clinical and Recovery Services' Occurrence processes, from Occurrence Level review to preparation for Effectiveness Assessments.
  • Ensure alignment of Occurrence documentation, process, and corrective action implementation with LiveOnNY policies, standards, and regulations. Proactively identify gaps and risk areas for the recommendation of Occurrence creation, integration, and/or revision.
  • Advocate for accurate and timely identification and documentation of events as Occurrences in LiveOnNY's Quality Management System as per policy.
  • Collaborate with internal partners to troubleshoot and escalate barriers to RCA scheduling, performance, documentation, and assessment. Proactively identify barriers to Occurrence-driven corrective action identification or implementation.
  • Review and recommend policies and procedures to ensure compliance with Occurrence and RCA strategies and tactics to meet organizational goals. Identify need for new policy development/changes to meet regulatory requirements.
  • Participate in Audits and Surveys as designated by departmental and organizational leadership to demonstrate and report out on Occurrences and their processes; collaborate with the Department of Process Transformation and Innovation to review and deliver Audit results into the Occurrence throughput as indicated; review subsequent corrective actions and effectiveness assessments as appropriate for the development of Internal Audit schedules and contents.
  • Conduct ad hoc audits of Clinical and Recovery Services as per request from interdepartmental leadership; proactively communicate ad hoc audit findings and interpretations with CQAPI and interdepartmental leadership.
  • Collaborate proactively with the Department of Process Transformation and Innovation to establish policy-appropriate schedules and tasks for occurrence-driven Internal Audit development to improve processes and outcomes throughout Clinical Operations.
  • Identify impacted departments and key stakeholders for Occurrence and RCA reviews; participate in standardized data report-outs of findings, corrective actions, and effectiveness assessments in departmental and organizational meetings as directed.
  • Coordinate and receive identified Missed Referrals and associated medical records from Medical Record Reviewers for timely and accurate review each calendar month, to clinically confirm and document patients' potential for Brain Death and DCD donation as per LiveOnNY policies, standards, and regulations.
  • Coordinate and communicate appropriate Clinical Review schedules with Medical Record Reviewers to facilitate timely UNOS submission of Monthly Donation Data Reports by LiveOnNY's Data Team.
  • Ensure accurate and timely documentation of Clinical Reviews to facilitate targeted education of healthcare partners by LiveOnNY's Hospital Services Specialists. Connects rationale for Clinical Review with documented clinical data in a clear and comprehensive manner.
  • Provide expertise for, and elucidate, clinical determination of Brain Death and DCD potential per CMS definitions as documented in hospital medical records and electronic donor records. Maintain up-to-date knowledge of Clinical Triggers as determined by policies, standards, and regulations.
  • Proactively identify existing or anticipated internal/external barriers and challenges to development, completion, or assessment of Clinical Review of Missed Referrals.
  • Proactively escalate undetermined Eligibility and/or Potential of Missed Referrals to CQAPI and Clinical leadership for timely review.
  • Participate in team huddles and organizational meetings, including meetings with organizational partners, regulatory agencies, and vendors as designated.
  • Proactively identify process improvement opportunities to departmental and organizational leadership, including recommendations driven by Occurrence and Clinical Review outcomes and organizational downstream impact.

Qualifications

Required:

  • 5 years clinical experience in an acute care hospital or ACLS setting OR 5 years experience as Transplant Coordinator performing active donor management at an OPO
  • 1 year experience in Performance/Process Improvement, Quality Assurance, or Regulatory in a healthcare setting

Preferred:

  • Degree in Healthcare Management, Healthcare Administration, or Informatics
  • 2 years experience conducting and documenting clinical data reviews in a healthcare setting
  • 2 years experience with Process Improvement methodologies such as Lean, Six Sigma, PDSA, RCAs, and/or A3 process mapping in a clinical/healthcare setting

Benefits

  • 403(b) deferred annuity
  • Medical/Vision/Dental/Life
  • Tuition reimbursement
  • Paid time Off
  • Pet Insurance
  • Life Insurance
  • Cellular plan discounts
  • Auto Insurance discounts

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