Job description

Job Announcement
Position Title: Clinical Quality Manager
Department: Administration
Supervised By: Chief Compliance Officer
Location: Alpine/Campo – Hybrid Position option available
Status: Exempt
Posted: November 2022
Closing Date: Until filled
Compensation: 2-5 years’ experience: $59,508 - $77,001.60
5+ years’ experience and/or licensed professionals): $77,000 - $103,100/year
Grant: N/A
Hours: Full time, Monday-Friday, 8:00AM-4:30PM

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GENERAL STATEMENT OF RESPONSIBILITIES*:
This position is responsible for developing, implementing, monitoring, and evaluating SIHC ‘s quality program, infection control, credentialing, and accreditation preparation programs to ensure it is aligned with the organization’s vision, values and goals. These programs include: safety, and quality focused healthcare and serving as the liaison between the patients and the Clinic. This position will regularly consult with the various department directors in reviewing benchmarking and quality measures to include quality improvement studies annually.

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SPECIFIC DUTIES AND RESPONSIBILITIES*:
Quality Program

• Responsible for coordinating and managing the Quality Management Program.
• Responsible for driving quality improvement throughout the organization to achieve the Triple Aim objectives of improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing costs by advancing a culture of quality using Lean and Six Sigma methodologies.
• Supervise the Quality Measures Data Analyst.
• Facilitate Quality Management Committee Meetings and maintain minutes.
• Develop, collect, revise, implement, and manage oversight of regulatory and compliance for ambulatory functions.
• Facilitates the development of and execution of ambulatory peer reviews.
• Oversees and develops assessment tools to track, analyze and present patient outcome measures, process improvement activities, program performance, and patient satisfaction.
• In collaboration with department directors, collects information on variance reporting and patient complaints to include follow through to ensure all are documented and closed. This then gets reported monthly to the Board of Directors.
• Identifies potential areas of ambulatory management compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues and provides general guidance on preventing similar occurrences in the future
• Identify through monitoring and audit activities operational and regulatory issues related to medical management ensuring that controls are in place and appropriate documentation
• Educate and train clinical staff on all OSHA standards.
• Provides support to program managers when drafting program manuals and clinical guidelines.
• Providing training on universal program policies or procedures, including clinical documentation
• Collaborates with QA Data Specialist in utilizing qualitative and quantitative data to conduct program evaluations and assisting with the development of data collection instruments, and producing quarterly performance reports for program departments
• Serves as the OSHA Compliance, Safety, and Risk Management Officer.
• Serves as the Privacy Officer.
• Leads and directs process improvement activities that provide more efficient and streamlined workflows in the clinics. Presents results of improvement efforts and ongoing performance measures of clinical processes to senior management.
• Provides support for operational reviews of clinical performance measures. Collaborates with department Directors in implementation of identified corrective actions.
• Develops Failure Mode Effects Analysis (FMEA) in collaboration with executive management and Board of Directors and actively manages the environment to ensure timely detection of potential risks and threats. Periodically reviews FMEA to ensure it remains relevant in an evolving healthcare environment.
• Provides recommendations and updates the Quality Management Program Plan annually and presents to Administration and Board of Directors.

Infection Control

• Develops, collects, revises, implements and manages infection control for all SIHC.
• Coordinating the infection control risk assessment in conjunction with the Infection Control designees for both medical and dental department.
• Creates, reviews and revises policies and procedures, including, but not limited to Infection Control, Safety, and Emergency Preparedness.
• Making recommendations regarding the prevention and control of infection as needed.
• Continual Evaluation of the Infection Control plan for goal achievement
• Ensuring the completion of audits regarding the implementation of and compliance with selected policies
• Providing education and training for all staff members
• Liaise with appropriate Department Directors regarding the development of standards and audits.
• Presents/provides the infection prevention report to the Chief Compliance Officer, Chief Operations Officer, Chief Executive Officer, and Board of Directors.
• Cooperating with the county and state department of health regarding infectious and communicable disease reporting.

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Credentialing*

• The Clinical Quality Manager is responsible for the management of initial and renewal credentialing process associated with appointment and reappointment of practitioners on behalf of the organization, ensuring that all credentialing, privileging, and accreditation processes and procedures are completed in accordance with established regulatory and policy requirements. Prepares for and coordinates credentialing audits in compliance with the managed care delegated credentialing contracts.
• Coordinates the management of the expirable process to ensure all clinical provider licenses, certificates, CME’s and CUE remain current, ensuring appropriate notification prior to expiration. Prepares fcor and coordinates credentialing audits in compliance with the managed care delegated credential contracts. Coordinates the management of credentialing database and associated modules, ensuring accuracy of data and reporting to downstream systems. Monitors critical data for extensive analysis and report generation.
• Supports performance improvement activities throughout SIHC at least annually.
• Ability to work a flexible schedule may be required based on need.
• Other duties as assigned.

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QUALIFICATIONS*:
Education/Experience: Education, training and/or experience which clearly demonstrates possession of the knowledge and skills stated above. Degree preferred. Two or more years of healthcare experience relating to process and performance improvement and risk management in a public or private healthcare facility. Supervisory or management of staff experience required. Staff training. Healthcare accreditation agency (AAAHC, JCAHO, CARF, CCL, etc.) experience required.
Licenses/Certifications:

• Current California LVN or RN License preferred.
• A valid California driver’s license is required at the time of appointment and must be maintained throughout employment.
• Applicant must be insurable under SIHC vehicle insurance policy at the time of hire and throughout employment.
• Certifications and/or licenses appropriate to the positions required education and profession must also be valid and maintained.

Character: Applicants must have a reputation for honesty and trustworthiness. Must be responsible and able to exercise good judgment, accept administrative supervision, pay attention to detail, follow instructions, including the ability to interact effectively and communicate with people in a professional and courteous manner. Must be highly confidential and work as a team with other staff. Applicant should be sensitive to client’s needs.
Skills: Strong supervisory, leadership, team building, interpersonal, and organizational skills. Ability to establish and maintain effective peer relationships with coworkers within the Medical Department, clinic-wide, and the public. Must be able to express ideas clearly, concisely, address audiences effectively, and exercise balanced judgment in evaluating situations and making decisions. Willing to be part of a team and cooperate in accomplishing department goals and objectives. Ability to prioritize, meet deadlines, take initiative, be proactive, and function in a rapidly changing environment. Ability to work with people of all social and ethnic backgrounds and to resolve conflicts, negotiate situations, and facilitate consensus.
Physical and Personal Requirements: Normal clinic/office environment. Sit or stand for long periods of time. Reach, bend, climb, stoop, lift up to 25 lbs. repetitive hand movement; use and view PC. Travel as needed.
Other: Applicants must successfully pass a pre-screening, including a tuberculin skin test or x-ray and a blood/urine drug screening test. Health must be adequate to perform all duties of the position. Applicant must complete SIHC Application and Authorization Form, both must be submitted to Human Resources prior to the close date indicated.
INDIAN PREFERENCE:
INDIAN PREFERENCE: In the filling of any SIHC job vacancy, preference may be given to qualified Native American Indians, pursuant to the Indian Preference Hiring Act, 25 USC 472, unless other laws require the filling of a vacancy without regard to Indian preference (e.g. Public Law (P.L.) 94-437, “Indian Health Care Improvement Act (IHCIA). To receive Indian preference for any SIHC position, the applicant must be enrolled, or be eligible for enrollment, as an American Indian with their Tribe, or must be certified as an American Indian from the designated Tribal Representative. Applicants claiming Indian preference must attach verification of their claim to the SIHC application, including Certification of form BIA-4432, which is available from the SIHC Human Resources Department. If verification is not or cannot be verified, the applicant will not receive Indian preference for purposes of the interview.

Job Type: Full-time

Pay: $42,000.00 - $103,100.00 per year

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