Quality Improvement Director - Healthcare jobs in Gaithersburg, MD

Overview  

Prestige Healthcare Resources Inc (PHRI) is seeking an experienced, pro-active, thoughtful team member who can make a substantial and valuable impact to the organization. We currently provide services to over 1,500 patients in two different states. We are in growth mode and looking to scale to providing care to over 10,000 patients in 5 different states over the next 3 years. Our focus is advocating and implementing an integrated care model approach to the underserved population undergoing behavioral health related issues. 

Providing compassion and care isn’t just our profession, it’s our passion…and our culture. At Prestige, we care for the clients that we serve. We listen to them and provide the support they need to enable them to live comfortable and fulfilling lives. Our drive is to restore hope and healing to the community. We are looking for mission-driven individuals looking to make a difference. 

Position summary 

The Director of Quality Assurance and Improvement (QA/QI) position is a supervisory position and reports directly to Chief Compliance Officer, (COO). The Director of QA/QI designs, implements, and oversees system level continuous improvement to ensure effectiveness and compliance associated with internal and external organizational processes and functions. 

Primary duties & responsibilities 

• Conduct thorough quality audits and analyze data related to service provision, consumer care, and regulatory compliance.  

• Provide strategic guidance on quality improvement initiatives to enhance operational efficiency.  

• Oversee incident reporting processes, event monitoring, grievances, and consumer satisfaction surveys.  

• Collaborate with cross-functional teams to address quality-related issues and implement corrective actions.  

• Stay updated on industry best practices and regulatory changes to ensure compliance 

• Establishes and maintains collaborative relationships with internal/external partners to ensure timely and accurate complaint resolution. 

• Establish and maintain collaborative relationships with internal/external partners to ensure timely and accurate complaint resolution.  

• Reinforce, emphasize, and monitor the importance of safe and professional high-quality customer service provided by Service Delivery Contractors. 

• Assist in the development, implementation, and maintenance of policies, procedures, and workflows related to clinical Quality Assurance.  

• Oversee the development of internal operational audit tools and data reporting, including specialized audit tools for specific government partners based on varying contractual requirements.  

• Evaluate, develop, implement, and maintain the Quality Plan and its role in operations, including quality reviews, action plans, staff training, and communication.  

• Coordinate with Compliance to address overlapping issues and QA/QI activities associated with corrective action plans from clinical chart audits.  

• Assist in leading, developing, and training PHRI staff on structured quality improvement methodologies and tools for proper identification of QI projects, goals, and work plans.  

• Deliver monthly quality reports, internal audit reports, annual quality plans, and audit plans as required by the COO.  

• Please note that the statements above describe the general nature and scope of the work performed in this position and do not encompass all responsibilities, duties, and skills required. Other duties may be assigned as necessary. 

Experience and Professional Qualifications 

• Master's degree in nursing, health services administration, public health, or a related field, accompanied by a minimum of 3 years of experience in overseeing corporate compliance and quality improvement programs within a healthcare environment in a managerial capacity. Alternatively, a Bachelor's Degree in a related field with at least 5 years of experience managing projects within a quality assurance/improvement setting.  

• Proficiency in Microsoft Outlook, Word, Excel, and other standard software applications.  

• Ability to work independently with minimal supervision, effectively plan and schedule work, multitask, and prioritize in a fast-paced environment.  

• Effective verbal communication skills when interacting with external organizations, vendors, and clients professionally and confidentially.  

• Detail-Oriented with a focus on accuracy and precision.  

• Strong analytical and problems-solving abilities to identify and address quality issues effectively. 

• Flexibility to adapt to changing priorities and excel under pressure.  

Supervision given 

This position is supervised by the Chief Compliance Officer and supervises the QA/QI Specialist.