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  • Albuquerque, New Mexico, Position Summary: Direct, plan, implement and monitor complex risk management investigations. Examine institution wide issues and prepare root cause analyses (RCA). Develop action plans, monitor milestone completion; audit compliance and analyze trends associated with clinical operations risks identified at the Health System. Prepare and present a variety of risk management reports and develop and conduct training sessions. Ensure adherence to Hospitals,departmental policies and procedures, and accreditation requirements. No patient care assignment. Accountability: RISK MANAGEMENT - Manage complex risk management investigations, including the institution wide root cause analysis (RCA) process analyses and prepare root cause analyses (RCAs) to meet organizational needs; integrate with Health Sciences Center risk management RISK IDENTIFICATION - Conduct chart reviews and develop case summaries and timelines; review variance reports and investigate cases as appropriate; identify cases that meet TJC sentinel event criteria REPORTS - Draft RCAs, including action plans and distribute drafts for comments; track and trend RCA data and prepare and present reports of findings RESEARCH- Research standards of practice and best practices and recommend system redesign projects to reflect these standards and practices, in addition to accreditation requirements COMPLIANCE - Audit medical records and conduct interviews to assess the effectiveness of the action plan implementation and and to ensure sustainability of system redesign TRAINING - Develop training materials and conduct training in-services POLICIES & PROCEDURES - Draft and review policies, procedures and guidelines COMMITTEES - Participate in committees, which may include: Nursing Quality Council, Nursing Peer Review Council and Medication Safety Committee OTHER - Provide coverage in the absence of the Exec Dir Risk Management Education Requirements: Bachelor's Degree in related discipline Experience Requirements: 2 years directly related experience Physical Demands Requirements: Sedentary Work: Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. Licensure/Certification Requirements - Preferred: Licensed Registered Nurse (RN) in State of New Mexico or as allowed by reciprocal agreement by State of New Mexico Professional licensure as appropriate to the clinical objectives of the unit: Licensed Registered Nurse (RN) in State of New Mexico or as allowed by reciprocal agreement by State of New Mexico Working Conditions Requirements: No or min hazard, physical risk, office environment May be exposed to infectious agents and blood-borne pathogens May be required to perform subordinate tasks in high census/vol
  • Long Beach, California, JobDescription The Application Data Analyst supports operational processesand internal process improvement initiatives to advance the reliability of careand outcomes across the health system. Under the guidance of the Manager ofPhysician Quality & Patient Safety, the Application Data Analyst willinteract with executive management and other key management staff, teams ofclinicians, support department staff and peer review coordinators. TheApplication Data Analyst identifies and supports areas of analytical focus forthe organization's quality of service, care delivery performance, and evaluationof potential areas of opportunity and risk. The Application Data Analystcreates and utilizes internal analytical tools/data sets (e.g. risk data,claims data, financial data, clinical/provider data) to produce meaningfulreports for key stakeholders' interpretation and dissemination.   Essential Job Functions Participates with medical staff leadership and physicians/clinicians to identify and facilitate implementation of best practices and enhancements to processes or stands to support mitigation of risk and improvement of quality. Produces reports and presentations on quality and conducts drill down analysis to proactively identify specific variance in practice patterns. Works collaboratively with report requestors, providing guidance to define repot requirements and validate results. Functions as a workgroup or team leader for portions of large and/or entire small projects, including system/practice implementation, service line quality initiatives, and re-engineering of current processes. Participates in the education and training of physicians & staff related to applications (Crimson) and analysis /coordination through on-the-job instruction, and formal training programs. Identifies opportunities for operational inefficiencies and collaborates with QA leadership for implementation. Uses Lean principles in work processes. Works collaboratively across departments to understand and meet the organization's clinical quality analytic needs. Coordinates and provides on-going technical support and training to physicians and management. Meets productivity and timeline targets and uses tools to track activities and timelines. Ability to rearrange work schedule to accommodate department meetings/medical staff committees. Performs other administrative duties as assigned.
  • Long Beach, California, Position Summary: The Quality Assurance Clinical Coordinator is responsiblefor leading, developing and coordinating the measurement, analysis andimprovement of quality at Long Beach Memorial (LBM), and Miller Children's andWomen's Hospital Long Beach (MCWHLB) through multidisciplinary Care-Line teams,unit-based PI teams and other hospital structures.   Essential Job Outcomes & Functions: Develops a plan and coordinates ongoing data collection for the measurement, assessment, and improvement of outcomes. Reviews, coordinates, and authors/create reports as necessary to ensure appropriate communication and reporting of performance improvement and quality control activities throughout the Medical Center. Maintains comprehensive clinical knowledge of specified patient population. The Quality Assurance Clinical Coordinator is responsible for leading, developing and coordinating the measurement, analysis and improvement of quality at Long Beach Memorial (LBM), and Miller Children's and Women's Hospital Long Beach (MCWHLB) through multidisciplinary Care-Line teams, unit-based PI teams and other hospital structures. Maintains comprehensive knowledge of clinical data acquisition methodologies, data correction methodologies, and data entry methodologies for assigned measures and data bases. Attends and participates in department education and training in-services. Provides leadership and participates in various Quality Council level meetings. Act as a consultant to hospital staff, physician, and hospital leadership related to measure definitions, inclusion/exclusion criteria, documentation requirements, etc., providing education as needed, including timely updates when definitions and guidelines are changed. Promotes the Performance Improvement model with Hospital Departments and Care-Line Teams for both strategic and specific PI projects. Provides ongoing education and training services throughout medical center including but not limited to prioritization, facilitation, and communication of performance improvement projects. Identifies areas for improvement and recommends/facilitates action plans to improve performance. Responsible for timely data retrieval, data entry, and data submission taking into consideration internal and external reporting requirements. Identifies critical information that could be evaluated and used during the reappointment process of the medical staff. Recognizes variance as an opportunity for improvement. Assists with ongoing survey preparedness and continuous readiness. Ensures and promotes regulatory compliance through survey readiness activities and storyboard identification and preparation. Conducts ongoing survey of departments assigned related to compliance with Joint Commission, CMS Conditions of Participation, Title 22,etc. Completes a report of survey findings and reports back to department leadership. Consistently applies infection control policies/procedures. Maintains a high level of confidentiality in all aspects of performance. Protects confidentiality of medical record during any review process. Collection and utilization of physician specific patient care information for internal quality improvement use only. Blinds physician specific information for broad internal or any external presentations. Maintains confidentiality of discussions occurring at medical staff committee meetings. Secures any necessary consents for release of information as indicated by Medical Executive Committee (MEC). Performs other duties as assigned.
  • Palm Coast, Florida, Description Risk Management & Regulatory Compliance Coordinator AdventHealth Palm Coast   Location Address:  60 Memorial Medical Parkway Palm Coast, Florida 32164   Top Reasons To Work At AdventHealth Palm Coast Career growth and advancement potential Health Insurance Coverage High quality of life with low cost of living on the shores of Palm Coast. Work Hours/Shift: Full Time   You Will Be Responsible For: Serves as a hospital content expert on performance improvement projects, accreditation and safety. Provides leadership and support regarding questions from staff, leaders and physicians on performance improvement, quality projects, regulatory and accreditation. Utilizes outside resources for complex questions to ensure correct communication and interpretation (i.e. TJC intranet, ECRI, QualityNet websites). Participates in collaboration with or as the designee for the Quality Director, on AHS quality initiatives and/or collaboratives. This may include but is not limited to: Glycemic management, Partnership for Patients/HIIN, AHRQ safety indicators as assigned. Assists with data management, performance improvement, medical record review and meeting organization to help ensure initiative success and goals are met. Utilizes appropriate PowerInsight (PI) reports to coordinate performance improvement and safety projects. This position represents the Office of Clinical Effectiveness at medical staff committees, performance review councils, and hospital leadership meetings by providing regulatory, quality and safety updates as assigned.  Responsible for maintaining daily screening process for all inpatient admission throughout hospital. Utilizes appropriate PI reports as verification tool to ensure all patients with coded diagnosis for core measure conditions after discharge have all appropriate safety measures addressed. Plans, implements & monitors interventions to ensure evidence-based practices are implemented and participates in and/or leads performance improvement committees and teams. Prepares reports and statistical analysis for medical staff and hospital leadership meetings.  Routinely utilizes sensitivity and diplomacy in daily interactions with others as many deal with sensitive, confidential or controversial information.  Patient safety and/or risk management designee when Quality Director and Risk Manager are out of the hospital or need additional support. Complete and analyze quality event timelines, root cause analysis timelines, review core measure cases, review risk events, notify regulatory bodies of any Code 15 or other reportable events, and identify care variation in case reviews.  Responsible for all incoming and outgoing sensitive regulatory correspondence, ensuring appropriate follow-up, including drafting of response correspondence.  Provides analysis of provider-specific and Quality Advisor reports from the Premier database and produces recommendations for performance improvement projects to hospital leadership. Assists Quality Director and/or Quality Manager, as assigned, to help with quality and safety initiatives throughout the year. Performs other duties as assigned. This includes, but is not limited to, maintaining department files in compliance with regulatory guidelines and maintain intranet for accreditation, patient safety, and performance improvement. Qualifications What You Will Need: KNOWLEDGE AND SKILLS REQUIRED: Strong computer skills in Microsoft Office Suite (i.e., Word, Excel, Access, PowerPoint, Outlook) Excellent communication skills- written, oral and presentation - to build relationships with all departments, physicians and executive team Must possess presentation skills, as well as negotiation and advocacy skills when interacting with fellow members of the healthcare team as well as outside accrediting agencies, legal bodies, and other healthcare institutions. Internal and external contacts are often problem-driven Analytical ability to interpret data trends Acts independently and demonstrates organizational and problem-solving skills Facilitation of various PI methodologies (Six Sigma, Lean, PDSA, etc.) PREFERRED EDUCATION AND EXPERIENCE REQUIRED: Bachelorâ™s degree OR 5 yearsâ™ clinical experience Minimum of 3 years healthcare experience Preparing and presenting professional presentations to executive leadership teams Accreditation activities and survey preparation Provider performance improvement activities   EDUCATION AND EXPERIENCE PREFERRED: Bachelorâ™s degree in a healthcare related field Experience with regulatory, patient safety, Peer Review or OPPE process Healthcare related performance improvement or project management experience Proven ability in areas of leadership/ supervision, knowledge of regulatory aspects of healthcare, QA/QI principles, education and outcomes   LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED: Six Sigma Performance Improvement Certification LEAN Performance Improvement Certification Team STEPPS Certification Certified Professional in Healthcare Risk Management (CPHRM) Certified Professional in Patient Safety (CPPS) Certified Joint Commission Professional (CJCP) Certified Professional in Healthcare Quality (CPHQ)   Job Summary: The Risk Management & Regulatory Compliance Coordinator provides leadership for safety, accreditation and regulatory activities through relationship with hospital administration and leadership, medical staff leadership, physicians, nurses, and ancillary and allied health departments to improve knowledge and performance for hospital safety, performance improvement and quality initiatives. Assists in the oversight of department staff as directed by the Director and/or Quality Manager. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. Provides concurrent case reviews and recommendations to ensure that evidence based best practices are implemented timely.  Responsible for independent coordination of program submissions in compliance with federal guidelines. Liaison for the medical staff physician Medical Review and OPPE/FPPE process. This position represents the Office of Clinical Effectiveness at medical staff committees, new hire orientation and hospital leadership meetings by providing accreditation, regulatory, quality and safety updates. Coordinates annual accreditation activities. Serves as the patient safety designee as needed. Responsible for planning, implementation & monitoring of interventions to ensure evidence-based practices are implemented and participates in and/or leads performance improvement committees as directed.  Prepares reports and statistical analysis for medical staff and hospital leadership meetings.  Routinely utilizes sensitivity and diplomacy in daily interactions with others as many deal with sensitive, confidential or controversial information. Adheres to and enforces the Florida Hospital Corporate Compliance Plan, the rules and regulations of all applicable local, state, and federal agencies, and the standards of applicable accrediting bodies.  Ensures facilitation of the patient grievance process as required by state and federal statutes. Adheres to and enforces the Florida Hospital Corporate Compliance Plan, the rules and regulations of all applicable local, state, and federal agencies, and the standards of applicable accrediting bodies. This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
  • Maitland, Florida, Description     Senior Risk Manager Registered Nurse  AdventHealth      Work Hours/Shift: ⢠          Full Time: M-F 8a-5p   You Will Be Responsible For:       Develop risk and safety strategy at the campus and system level in collaboration with senior leaders, medical staff, clinical leadership, performance improvement, and IP - both at in the inpatient and outpatient environment. Identify, develop and implement proactive safety improvement and risk reduction strategies for unit, campus, and system level process opportunities. Operations related to the Risk Management Program and related patient safety initiatives for the system. Implements risk management plan for assigned areas Responsible for maintenance of regulatory requirements for risk management programs including oversight of the event report review, grievance process, and reporting requirements for assigned facilities.       Qualifications What Will You Need:            EDUCATION REQUIRED : Bachelor's Degree in Clinical, Healthcare or Business Administration   Education Preferred : Masterâ™s Degree in Clinical, Healthcare or Business Administration          EXPERIENCE REQUIRED : If Clinical: Three years of clinical experience One year of healthcare risk management experience or successfully facilitating significant quality and/or safety initiatives   OR If Non-Clinical: Five Years of healthcare risk management experience or successfully facilitating significant quality and/or safety initiatives   Experience Preferred : Supervisory, leadership and/or people management experience          LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED : If Clinical, active Florida license or certification as one of the following: Registered Nurse ARNP Respiratory Therapist Occupational Therapist Physical Therapist Speech Pathologist Radiology Technician Ultrasound Technician Physician Assistant Paramedic Pharmacist   Job Summary: The Senior Manager of Risk directs day to day risk operations of multiples facilities (acute care campuses, outpatient centers, free-standing emergency centers, Healthcare University....and Church) with approximately half-million visits per year. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.     This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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