Job Description

JOB PURPOSE: Under the general direction of the Chief Operations Officer, The Director of Clinical Quality will assume the responsibility of the Inspire Health Medical Group’s quality assurance and risk mitigation activities, to ensure regulatory compliance for our private practice locations.

JOB FUNCTIONS:

Regulatory Compliance

• Manage licenses, certifications and annual competencies for all clinical staff
• Maintain and manage specialty specific accreditation standards/programs.
• Ensure organizational compliance with all State, Federal, and local regulations, including OSHA, HIPAA, CLIA, license requirements and guidelines.
• Maintain current knowledge of regulatory standards and ensure timely dissemination to practice leadership.
• Oversee Infection prevention programs, implements quality improvement initiatives, ensures regulatory compliance, and leads staff education and risk assessments to ensure patient safety and optimal clinical care.
• Identify infectious disease processes, help in surveillance and epidemiologic investigations, help prevent and control the transmission of infectious agents.
• Serve as liaison between Inspire Health Medical Group and regulatory bodies, insurance plans, or external auditors for clinical and compliance matters.

Quality Program Compliance

• Develop, update and manage Inspire Health Medical Group clinical policies and procedures in collaboration with medical leaders.
• Lead the improvement and ongoing management of Quality and Risk Management processes for all practice sites.
• Analyze clinical data to identify trends, measure performance, and generate reports for management and stakeholders and report potential quality issues to the Chief Compliance Officer.
• Participate and oversee site audits and inspections. Implement and tracking of corrective action plans.
• Responsible for responding, investigating, and reporting any adverse events to the Chief Operating Officer and Chief Compliance Officer.
• Assist in evaluating and supporting the development of new clinical service lines.

Clinical Training/Oversight and Electronic Medical Record (EMR) Support

• Develop back-office protocols and procedures related to patient care. Ensure consistency in implementation throughout all practice sites.
• Plan and conduct training programs for new clinical personnel; manages ongoing in-service education and annual competency assessments.
• Oversee employee immunization and clinical screening test requirements, collaborating with HR for documentation.
• Provide support for clinical builds and clinical staff/provider training within the EMR environment.

Additional Functions

• Other assigned duties related to job function, as required to meet company performance standards.

Requirements

Education:

• Current California RN license required, NP preferred.
• Bachelor’s degree in Nursing or related field, Masters preferred.

Experience:

• Education/training experience preferred.
• Quality management experience, preferably in a medical practice setting.
• Minimum three (3) years of experience and knowledge of clinical practices, standard health care policies and procedures.

Other Requirements:

Current American Heart Association BLS certification

PERFORMANCE REQUIREMENTS

Knowledge:

• Knowledge of Continuous Quality Improvement (CQI) principles, practices, methods, and tools.
• Knowledge of computer applications used in Quality Measures and Quality Programs (including MIPS), with proficiency in data analysis and spreadsheet tools.
• Knowledge of medical records and clinical care processes.
• Knowledge of EMR builds and clinical care workflows.

Skills:

• Skill in effective education and facilitation of training clinical team members in medical practice.
• Skill in application of tracking and reporting methodology using available software by developing appropriate reports.
• Skill in conducting Quality Improvement (QI) checks of medical records and other clinical documentation.
• Must have strong computer skills and knowledge of Microsoft Office Suite.

Abilities:

• Ability to educate staff in both verbal and written communication about clinical topics and risk management procedures in formal and informal settings.
• Ability to interact effectively with health care team members.
• Ability to analyze data, identify trends, and implement corrective actions.
• Work collaboratively and have effective communication with midlevel providers and physicians.

Equipment Operated:

• Standard office equipment including computer hardware and software.

Work Environment:

• Combination of physician office and classroom settings.
• Position in a well-lit, well-ventilated office environment. Frequent contact with a variety of people with occasional patient contact.

Mental/Physical Requirements:

• May occasionally need to lift/carry/move audiovisual equipment weighing up to 25 pounds.
• Occasional stress related to deadline pressure.

Safety:

• All employees are responsible for complying with safe and healthful work practices as outlined in the Company’s Employee Safety and Injury and Illness Prevention Program and policies and procedures specific to their department needs.