Quality-Patient Safety Program Mgr - Clinically Licensed
Quality-Patient Safety Program Mgr - Clinically Licensed
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Salary Not Disclosed
1 Vacancy
Job Description
Overview
Welcome to Saint Joseph London a 150-bed regional hospital founded in 1926. Located on a 52 acre healing environment Saint Joseph London offers private patient rooms that overlook a small lake and healing garden and has been recognized as a Best Place to Work in Kentucky for five years in a row (2020-2024).
Whether you are an experienced healthcare professional or working toward that we invite you to experience Hello Humankindness with us! CHI Saint Joseph Health provides you with the same level of care you provide for others. Learn more about CHI Saint Joseph London and its awards and recognitions here: CHI Saint Joseph London
Our commitment to serve the common good is delivered through the dedicated work of thousands of physicians advanced practice clinicians nurses and staff; through clinical excellence delivered across a system of 140 hospitals and more than 2200 care centers serving 24 states.
Responsibilities
The primary function of the Quality/Patient Safety Program Manager is to support coordinate and facilitate the quality
management (QM) patient safety (PS) and regulatory performance improvement (PI) activities for the hospital and
medical staff. This role also serves as a resource to employees management nursing directors senior management
councils physicians and teams on quality management activities and will handle patient sensitive and confidential
hospital information.
ESSENTIAL KEY JOB RESPONSIBILITIES
Assists in the design planning implementation and coordination of Quality Management Patient Safety and
Performance Improvement activities for assigned hospital and medical staff departments committees divisions service
lines and functions. Proactively coordinates and facilitates performance improvement teams to support key initiatives
including but not limited to activities focused on clinical quality improvement patient safety and risk reduction patient
experience efficiency FMEAS root cause analyses and medical staff improvement (e.g. case review for peer review
OPPE FPPE).
Participates in an integral role to ensure compliance with CMS HIQRP/HOQRP TJC Leapfrog etc. data collection and
reporting of process and outcome measures. Facilitates development and implementation of data collection tools and
processes including the ability to: identify data elements needed to complete appropriate measurement perform data
collection and abstraction per specifications and validate data prior to submission or preview reports prior to
publication.
Facilitates meetings presents data and reports identifies key findings and assists with action plans and implementation.
Maintains current knowledge of accreditation and licensing requirements and must be a resource to staff on these
regulations in order to improve management of outcomes and ensure compliance. Assists with regulatory readiness and
survey preparation activities including mock survey tracers.
Qualifications
Required Education and Experience:
- Licensed Registered Nurse Licensed Clinical Pharmacist or other
Licensed Clinical Staff and three (3) years clinical experience in an
acute care setting - Must be able to perform case reviews for medical staff peer review
and medical and/or surgical Registry Abstraction - One (1) year healthcare-related quality management/performance
improvement experience (e.g. chart audit PI team member etc.)
Required Licensure and Certifications:
- Current state license in a clinical field in state of practice.
- Certified Professional in Healthcare Quality (CPHQ) or Healthcare
Quality and Management Certification (HCQM) or Certificate of
Professional Healthcare Quality and Patient Safety (CPQPS) within 2
years of employment is required.
Required Experience:
Manager
Employment Type
Unclear
