Provides leadership and support in establishing and directing the Quality Improvement Program consistent with the plan directives.
Develops and/or maintains QI policies and procedures that meet State, Federal legal requirements and standards.
Collaborates with physicians to design and oversee implementation of the clinical quality improvement initiatives.
Works closely with the Compliance Officer to maintain compliance with all business specific rules, regulations and standards: i.e. CMS
Facilitates, integrates, and/or coordinates the development, design, implementation, and evaluation of identified quality improvement activities.
Promotes understanding, communication and coordination of all quality improvement program components and the continuous quality improvement.
Participates in various evaluations and audits.
Coordinates reporting on quality initiatives to all appropriate committees by ensuring that standard owners have completed a report, performed a preliminary analysis of data, and presents the findings and recommendations for improvement.
Effectively manages department staff to accomplish departmental goals.
Develops operating and capital budget proposals.
Maintains QI program documents, reports, and committee minutes and follows all internal privacy and confidentiality policies and procedures.
Maintains current knowledge of regulatory requirements associated with the QI program.
Oversees HEDIS data submission process.
Leadership of accreditation efforts (URAC).