Demo

Area Quality Leader

Fox Point Recruitment LLC
Santa Clara, CA Full Time
POSTED ON 1/21/2025
AVAILABLE BEFORE 4/21/2025

Responsibilities :

  • Drives clinical quality and safety programs.
  • Responsible for the strategic development, planning and control of health plan and hospitals quality programs.
  • Leads the implementation of compliant programs at the facility, including associated alliance hospitals and other non-KFH facilities.
  • Facilitates the development of programs and processes that meet regulatory requirements.
  • Focuses on organization-wide systems and processes for improvement, including clinical quality management, risk management, AR&L and patient safety activities in collaboration with clinical and administrative personnel.
  • Serves as Patient Safety Officer for assigned hospitals.
  • Oversees and facilitates internalization and monitoring of Regional Sub-regional Services.
  • Ensures practitioner review and oversight meets internal standards.
  • Responsible for quality program oversight, associated medical staff issues, member concerns and grievances to ensure submission to accreditation and regulatory bodies are timely and accurate; and ensures that processes supporting submissions are reliable.
  • Facilitates health plan assessment of quality programs at the medical center including MDQR.
  • Develops strong collaborative leadership relationships with TPMG, external regulatory agencies, accreditation bodies, employer groups.
  • Has joint accountability to develop systems and corrective action plans for the facility to meet regulatory compliance.

Qualifications : Education :

Masters degree in Business, Health Care, Public Administration or related field.

Experience :

  • Minimum ten (10) years of experience in clinical and management roles in a health plan or multi-faceted health care system and multi-provider settings.
  • License, Certification, Registration :

    N / A

    Additional Requirements :

  • Thorough knowledge of quality assurance, quality improvement, utilization review, risk management, and accreditation and licensing requirements including The Joint Commission, NCQA, Knox-Keene Act, Federal HMO Act, CMS, Cal-OSHA, Public Employees Medical and Hospital Act, HIPAA and Medi-Cal regulations and standards.
  • Track record achieving superior results that demonstrate performance improvement and quality and service outcomes.
  • Must be able to work in a Labor / Management Partnership environment.
  • Preferred Qualifications :

  • Clinical license such as RN or Pharm. D preferred.
  • Non-Negotiable Requirements :

  • Must have director level experience as this is a Sr. Director level position.
  • Must have experience leading quality departments - direct oversight.
  • Must have RN or Pharm D, large hospital experience or multi-site experience, inpatient experience.
  • Nice-to-Have Skills :

  • CPHQ Certification.
  • HRO experience.
  • Lean principles experience.
  • Experience with Joint Commission and CMS.
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