- Quality & Education
- Scotts Valley, CA, USA
- 100000.00-150000.00 per year
- Salary
- Full Time
For Full Time Employees: employer pays 100% of employee premiums for medical, dental, vision, life and long-term disability
Job Summary
The Quality Manager (QM) is responsible for accurate and timely completion of key quality functions across all agency service lines. Primary duties include: oversight and implementation of the Quality Assessment Performance Improvement (QAPI) program; Infection Control and Employee Health Program; coordination and execution of all clinical audits. Additional responsibilities include supporting Process Improvement Projects (PIPs) and administration of Unusual Occurrence Report (UOR) system.
Essential Responsibilities
Quality Assessment/Performance Improvement
- Prepares and conducts quarterly QAPI meeting
- Ensures all routine quality data is collected and presented in a timely fashion
- Coordinates and ensures completion of clinical audits and quality surveillance
- Assists in response to audit requests, e.g., ADRs, SMRC, MAC, TPE
- Provides coaching/training for leaders and staff when areas are identified
- Manages Unusual Occurrence Report (UOR) system
- Serve as a member of the Project Advisory Council (PAC)
- Collaborates with Chief Clinical Officer in development and implementation of key quality-related activities across the organization, including:
- Quality and Performance Improvement policies and procedures
- Oversight of QAPI program and annual QAPI plan
- Implementation of appropriate quality monitors
Infection Control and Employee Health Coordination
- Develops and maintains all aspects of HSCC Infection Control Program
- Maintains policies, procedures and forms related to Infection Control and Employee Health
- Provides oversight of non-clinical staff assisting with Infection Control operations (e.g., contact tracing, annual employee clinic
- Develops training & in-service materials
- Oversight of Fit Testing program (Determination of staff to be tested, communication to staff/managers about Fit Testing, review of Fit results, mask ordering and stocking (in conjunction with operations), and follow up as needed)
- TB testing oversight (performs TB clinics and ad hoc screenings)
- Annual flu vaccine messaging, oversite and tracking
- Employee infection control tracking
Accreditation Coordination
- Participates in IDG Policy Review and SOP Review Committee
- Coordinates with accrediting body as directed by Chief Compliance Officer
- Prepares PER submission in collaboration with Chief Compliance Officer
Leadership:
- Articulate and support HSCC mission, vision and values through all Quality initiatives, strategy and transactions
- Create Quality/Infection Control trainings that support a culture of ownership and that align employee work and performance within that desired culture
Secondary Responsibilities:
- Backup for Director of Clinical Education
- Orientation for new staff
- Performs other related job duties as assigned by Supervisor
Compliance
- Ensures all HIPAA Privacy and Security Regulations, Medicare Conditions of Participation, and all other regulatory/compliance requirements are understood and followed
Requirements
Education/Experience
- Degree in Nursing from an accredited college, Preference to BSN
- Hospice, Quality Assessment/Utilization Review, and/or Computer Charting/Auditing experience required.
- Netsmart experience preferred
- Facility (SNF/RCFE) experience preferred.
Skills Required
- State & Federal hospice regulatory knowledge
- Systems development
- Organizational skills
- Technological skills including Excel, PowerPoint
- Communication & teaching skills
Certifications, Licenses, Registrations
- Require current California RN license, Preference to BSN
- Pass OIG/GSA review and all required background checks
Physical Demands
- Strength to lift and carry materials weighing up to 10 pounds
- Vision to read printed materials and a computer screen
- Hearing and speech to communicate in person and over the telephone
Work Environment/Environmental Condition
- Must possess mobility to work in a standard office setting and to use standard office equipment, including a computer
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