Quality Improvement Director - Healthcare jobs in Hawaii

Quality Improvement Director - Healthcare leads and directs process and overall quality improvement activities that produce better patient care and more efficient operations. Develops programs to review and evaluate patient care and outcomes. Being a Quality Improvement Director - Healthcare implements a strategy and plans for a quality improvement function within the facility in collaboration with the administrative and clinical leaders of the hospital. Tracks and presents results of improvement efforts and ongoing measures of clinical processes to management. Additionally, Quality Improvement Director - Healthcare requires a bachelor's degree. Typically reports to top management. The Quality Improvement Director - Healthcare typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Quality Improvement Director - Healthcare typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Manager, Quality Improvement
  • HMSA
  • Honolulu, HI FULL_TIME
  • Quality Improvement Operations
    1. Provide direction and manage HMSA's overarching Quality Improvement program, including the oversight of staff and necessary resources required to design and implement programs related to compliance with accreditation, regulatory and program requirements (e.g., NCQA, Med-QUEST, CMS, OPM, etc.). Oversee project teams and provide guidance to subject matter experts through planning, development, implementation, and evaluation to ensure programs meet standards, are measurable, and prepared for related audits.
      • Manage committees, delegated entities, and subgroups to comply with accreditation standards and regulations.
      • Select, develop, and manage staff. Provide coaching, feedback, and performance evaluations to ensure effective business practices and departmental goals are met.
      • Monitor and take appropriate action to ensure various task and system-related deliverables are accomplished in an accurate and timely manner.
      • Identify and actively resolve issues that hinder program efficiencies or outcomes.
    2. Manage and direct ongoing assessment of business functions for numerous departments within the scope of NCQA standards (e.g., Provider Services, Utilization Management, Medical Management, Integrated Health Management Services, Customer Relations, etc.) to support high-quality performance and ensure successful NCQA re-accreditation.
      • Assess business area functions against current and upcoming NCQA standards and identify potential performance gaps and associated risks.
      • Recommend and facilitate business area process improvements via means such as policies, workflows, and processes; follow-up to ensure improved outcomes.
      • Collaborate with cross-departmental teams to identify and implement organization-wide strategic initiatives that support HMSA's quality performance.
      • Every three years, serve as HMSA's internal lead for NCQA's re-accreditation review by gathering all necessary documents and information from business areas, managing timely document submissions to NCQA, facilitating NCQA requests for additional information, and coordinating onsite review activities.
    3. Create and foster working relationships with internal and external parties that facilitate accreditation/regulatory audit and QI program success. Responsible for serving as Program lead and/or co-lead of quality sub-committees.
      • Effectively conduct meetings and discussions to achieve consensus and to identify actionable tasks.
      • Achieve service commitments from core and support functional areas.
      • Prioritize, track, and manage program deliverables.
      • Ensure program documentation and reporting are complete and meet compliance requirements.
    Delegation Oversight and Collaboration
    1. Oversee accredited delegation relationships and quality improvement activities with HMSA's strategic partners and with key departments, including, but not limited to Medical Management, Medical Directors, Provider Services, and the respective product line owners to attain and maintain compliance in accordance with HMSA policies and procedures, federal and state laws and regulations, and accreditation standards applicable to the quality of healthcare delivery and clinical standards across all product lines. Provide education and training to stakeholders on their respective roles in carrying out these programs.
      • Develop and maintain delegation and contractual language that meets audit specifications and serves the best interest of HMSA's QI program. Participate in contracting activities, when appropriate.
      • Establish and ensure systematic oversight functions to manage change through change control and quality assurance workflows.
      • Oversee the development and implementation of work plans as appropriate and ensure follow-up to achieve compliance. In addition, ensure audit readiness for accreditation bodies such as NCQA, URAC etc.
      • Manage ongoing program dynamics ensuring the continued impact and performance of delegates.
      • Ensure changes to program components are analyzed, fully communicated to impacted parties, and implemented in a timely manner.
    Complaints and Grievances
    1. Direct the provider service quality/quality of care complaint process related to the quality of delivery of healthcare services to ensure resolution and an integrated process with other HMSA departments and lines of business.
    2. Ensure ongoing reporting and analysis of trends related to complaints and appeals, making recommendations for improvement as appropriate
    Model of Care Effectiveness
    1. Manage staff charged with the oversight and maintenance of the Medicare Advantage Dual Special Needs Population (DSNP) Model of Care (MOC) Effectiveness Measures. Provide guidance to staff and internal business areas when opportunities for improvement are identified. Participate and support activities related to changes or revisions to the MOC.
    Administrative Functions/Miscellaneous
    1. Prepare annual unit plan and budget, monitor regularly, and take appropriate action to manage actual expenses again budgeted expenses.
    2. Performs all other miscellaneous responsibilities and duties as assigned or directed.

     

  • 2 Months Ago

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Director of Quality Assurance and Compliance
  • Waiakea Inc
  • Hilo, HI FULL_TIME
  • DescriptionPosition Overview As the Director of Quality Assurance and Compliance for Waiakea Inc., you will play a crucial role in overseeing and optimizing our quality and sanitation processes to ens...
  • 14 Days Ago

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Sales Associate
  • Lowe's Home Improvement
  • Kahului, HI FULL_TIME
  • Competitive Pay, Great Benefits and Monthly Bonus Potential of up to $1200! What You Will Do All Lowe’s associates deliver quality customer service while maintaining a store that is clean, safe, and s...
  • 6 Days Ago

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Registered Nurse / Home Healthcare
  • Cross Country Healthcare
  • Kaneohe, HI FULL_TIME
  • Job DescriptionAs a home health nurse (RN HH), you will deliver healthcare in patients' residences, helping them maintain their independence. You will provide one-on-one care for patients in their hom...
  • 11 Days Ago

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Process Improvement Manager
  • Pacific Shipyards International, LLC
  • Honolulu, HI FULL_TIME
  • Position Summary:: : The Process Improvement Manager will find ways to improve process efficiency while delivering maximum value to our customer base. This qualified candidate will design efficient sy...
  • 5 Days Ago

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Continuous Improvement Operator
  • Kimberly Clark
  • Kapolei, HI FULL_TIME
  • This job offer is not available in your country. Worker Type Employee Worker Sub-Type Regular Time Type Full time 11 hours ago
  • 14 Days Ago

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Director of Healthcare Compliance - Integrity & Compliance
  • University of Mississippi Medical Center
  • Jackson, MS
  • Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center. Please rev...
  • 5/10/2024 12:00:00 AM

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Client Services Director, Simpson Healthcare
  • IQVIA, Inc.
  • Old Lyme, CT
  • Client Services Director, Simpson Healthcare JOB SUMMARY The Client Services Director is responsible for optimizing the ...
  • 5/10/2024 12:00:00 AM

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Group Creative Director, Art (Healthcare)
  • VMLY&R Health
  • New York, NY
  • Description Position at VMLY&R Health Who we are: At VML, we are a beacon of innovation and growth in an ever-evolving w...
  • 5/9/2024 12:00:00 AM

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Associate Creative Director, Art (Healthcare)
  • VMLY&R Health
  • New York, NY
  • Description Position at VMLY&R Health Who we are: At VML, we are a beacon of innovation and growth in an ever-evolving w...
  • 5/9/2024 12:00:00 AM

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Hospice Director of Healthcare Partnerships
  • ambercare
  • Columbia, TN
  • Tenneesse Quality Care is seeking a Healthcare Partnership Director to join their hospice leadership team and support ou...
  • 5/8/2024 12:00:00 AM

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Director of Healthcare Compliance - Integrity & Compliance
  • UMMC - Recruitment
  • Jackson, MS
  • Director of Healthcare Compliance - Integrity & Compliance Directs and monitors the institutional healthcare compliance ...
  • 5/7/2024 12:00:00 AM

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Director of Healthcare Information Technology
  • Hamilton Barnes 🌳
  • Reno, NV
  • We are hiring a Healthcare IT Director to oversee the strategy, implementation, and progression of information systems. ...
  • 5/6/2024 12:00:00 AM

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Director of Healthcare Services
  • Dunwoody Village
  • Newtown Square, PA
  • Dunwoody Village is a mission-driven, single-site, not-for-profit Continuing Care Retirement Community (CCRC) with a 5-s...
  • 5/6/2024 12:00:00 AM

Hawaii (/həˈwaɪi/ (listen) hə-WY-ee; Hawaiian: Hawaiʻi [həˈvɐjʔi]) is the 50th and most recent state to have joined the United States, having received statehood on August 21, 1959. Hawaii is the only U.S. state located in Oceania, the only U.S. state located outside North America, and the only one composed entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean. The state encompasses nearly the entire volcanic Hawaiian archipelago, which comprises hundreds of islands spread over 1,500 miles (2,400 km). At the southea...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Quality Improvement Director - Healthcare jobs
$118,833 to $161,772

Quality Improvement Director - Healthcare in Killeen, TX
Healthcare organizations can change this wasteful trajectory by applying quality improvement methods to improve their processes.
January 22, 2020
Quality Improvement Director - Healthcare in New Haven, CT
Quality improvement leaders need to acknowledge and communicate to their teams that failure is not just acceptable, but that it is inevitable and even valuable for teaching lessons about people and processes.
December 06, 2019
Quality Improvement Director - Healthcare in Knoxville, TN
Quality improvement initiatives are a mainstay for hospital care teams.
December 11, 2019