Job Details

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Summary

The Senior Quality Specialist is responsible for implementing the SAMG (Saint Alphonsus Medical Group) Quality and Safety Plan as delegated by the SAMG Director of Quality. The position serves as a mentor and project lead providing guidance to less experienced staff members.

Employment Type

Full time

Shift

Day Shift

Senior Quality Specialist

Establishes and maintains a partnership with multiple stakeholders within SAMG, including physicians, operations directors, managers, nursing, staff and administration on quality and safety projects. Serves as a consultant to multiple stakeholders in developing solutions to clinical/compliance/standards of care issues and works to accomplish the strategic direction of SAMG and SAHS. Is actively involved in interfacing with the SAMG infrastructure on system wide collaboratives. Responsible for developing, quantifying and evaluating internal and external quality information and data into actionable intelligence to support the strategic objectives of the organization and to drive operational excellence. The position creates, manages, and reports on information for the network, and provides leadership to foster an approach to continuously improve patient care and quality within the system. Some local travel required.

Requirements

• Bachelor's degree required in Health Information, Public Health, IT, Healthcare Administration or Nursing.
• Master's degree strongly preferred.
• Licensed health care professional preferred.
• Minimum of three to five years of experience in data analysis, preferably in health care.
• Experience with HEDIS (Healthcare Effectiveness Data and Information Set), PQRS (Physician Quality Reporting System), and other health care quality metrics required.
• Experience with payers and quality desired.
• Must have active driving privileges.

What You Will Do

• Mentor and train quality specialists and oversee department projects and workflow.
• Lead in the development and administration of project work plans and timelines; depending on the complexity of the project, may manage the project budget.
• Develop and establish quality improvement measures and testing standards for new applications, products, and/or enhancements to applications.
• Analyze documentation and technical specifications of any new application under deployment or consideration to determine its intended functionality.
• Work with system stakeholders for alignment of Quality Metrics within multiple IT applications and contracts.
• Gather and manage data collection and mapping process from numerous sources; may oversee same process with staff.
• Validate and conduct quality assurance on data collected and oversee preparation of reports.
• Analyze patient care and practice patterns within nursing, ancillary and medical staff and identify issues with opportunities for improvement.
• Identify patient safety issues, events, trends and deviations from standard of care.
• Assist with creating reports needed for improvement activities.
• Analyze data and generate reports to identify significant and problematic issues and concerns, devise improvement plans and measure impact of actions with a focus on the defined population.
• Review clinical data from the electronic health record and paper based records, and develop data collection tools for population specific or focused review while maintaining clinical knowledge in practice guidelines and standards.
• Act as a resource to all clinics on quality metrics and implementation of corrective actions.
• Interface with practitioners to report, communicate and coordinate quality review data and performance outcomes.
• Educate clinic staff and providers on performance measures based on quality metrics and regulatory issues.
• Maintain knowledge of The Joint Commission (TJC) regulations and requirements, applicable CMS requirements, and payer requirements and have the ability to interpret and give guidance on fulfillment of these requirements.
• Oversee and monitor medical records forms development and database.
• Educate clinic staff and providers on performance measures based on quality metrics and regulatory issues (such as TJC and CMS requirements and CMS/payer quality initiatives, value based modifier programs, etc.).
• Create educational tools around regulatory requirements, Performance Improvement (PI) methodologies, and quality and safety goals for the organization, and have the ability to teach others to teach these subjects.
• Be able to examine performance and identify opportunities for improvement, meet with teams, facilitate the groups, and take data to action and results.
• Support various councils within SAHS and SAMG as directed, such as the Triad Council, the SAMG Quality Committee, and the Boise Unified Care Organization (UCO) Ministry team.
• Support and lead CHE Trinity Health collaboratives that impact SAMG, as directed.
• Assist in patient care excellence and Culture of Safety surveys as directed by the SAMG Director of Quality.
• Health care operations, medical billing and coding, health information technology knowledge required.
• Ability to read and interpret licensure, accreditation (The Joint Commission) and regulatory (Centers for Medicare and Medicaid) standards.
• Competency in multiple areas preferred, including group facilitation and leadership, process improvement methodologies as above, adult education and knowledge of healthcare organizational processes.
• Assist in teaching Patient Centered Medical Home (PCMH) concepts.

Colleagues of Saint Alphonsus Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout SAHS and Trinity Health.

Visit www.saintalphonsus.org/careers to learn more about the benefits, culture and career development opportunities available to you at Saint Alphonsus Health System.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Saint Alphonsus and Trinity Health are committed to promoting diversity in its workforce and to providing an inclusive work environment where everyone is treated with fairness, dignity and respect. We are committed to recruit and retain a diverse staff reflective of the communities we serve. Saint Alphonsus and Trinity Health are equal opportunity employers and prohibit discrimination against any individual with regard to race, color, religion, gender, marital status, national origin, age, disability, sexual orientation, or any other characteristic protected by law.