Description

The Corporate Director Quality-Facility Based Services is accountable for overall coordination and management of a corporate-wide integrated Quality Assessment and Performance Improvement (QAPI) program focused on the Oceans Behavioral Hospitals' inpatient and intensive outpatient programs. This position is also responsible for supporting the facility leadership in on-going preparation for regulatory and accreditation surveys. This position is responsible for the oversight of and provides leadership to quality support personnel at each facility.

Essential Functions:

1. Oversees corporate-wide facility-based performance improvement (PI) projects identified through the on-going data driven quality assessment and performance improvement programs.
2. Coordinates the Company's inpatient and outpatient facilities' data collection procedures and provides on-going support and education regarding tools and reporting requirements.
3. Utilizes data and collaborates with leadership to set priorities and provide guidance in their development of quality improvement work plans.
4. Assists Administrators and Directors of Nurses in the performance of root cause analysis, as indicated, to investigate potentially avoidable events.
5. Serves as a resource to the medical staff, administrators, and other staff.
6. Prepares reports for presentation to the Executive Quality Review Team.
7. Conducts training for staff on clinical chart audits, peer review, grievances and appeals, incident reporting, and other quality initiatives.
8. Keeps abreast of state and federal regulatory requirements and coordinates education for QAPI principles and regulatory standards as indicated.
9. Completes other assigned duties under the direction of the VP of Quality.

Requirements

Educational / Experience Requirements:

• Bachelor's degree or RN diploma or equivalent relevant work experience.
• At least five years healthcare experience related to clinical leadership and/or quality assessment and performance improvement.
• Behavioral health experience preferred.
• Licensed clinical professional in healthcare preferred, must be in good standing for the state in which licensure is held.
• Certification in Healthcare Quality (CPHQ) preferred.

Qualifications / Skills:

• Knowledge and understanding of CMS, Joint Commission, State Department of Health and Hospitals regulations and Federal Department of Health and Human Services regulations.
• Good written and oral communication skills.
• Demonstrates personal traits of a high level of integrity, team orientation, professionalism, and trustworthiness.
• Places a high value on ethical standards and treating others with dignity and respect.
• Maintains compliance with all Company policies and procedures.
• Demonstrates adequate computer skills to navigate MS office products and electronic QAPI software solutions.

Work Environment:This position will require 50% travel time. Subject to many interruptions. Occasional pressure due to multiple calls and inquiries. This position can be high paced and stressful; must be able to cope mentally and physically to atmosphere. This person might sometimes experience disagreeable odors, sights and/or unpredictable patient behavior. Work requires spending approximately 90% or more of the time inside a building that offers protection from weather conditions but not necessarily from temperature changes.