Hybrid Quality & Risk Manager - Relocation Available bei Weiser Memorial Hospital

Description

 Weiser Memorial Hospital--rated as one of Idaho's best places to work--is hiring an experienced Quality & Risk Manager. The Quality & Risk Manager is the identified representative to ensure the requirements of the Quality Management System (QMS) are determined, implemented, and maintained. The Quality & Risk Manager is responsible for the integration of the Quality Assessment and Performance Improvement (QAPI) Program, to improve performance, patient safety, and overall quality of patient care and operation. This role also oversees the Risk Management Plan, using data-driven results to address risks and opportunities in collaboration with Senior Leadership and engage and partner with Hospital managers to develop preventative controls minimizing negative effects and maximizing opportunities as they arise. The Quality & Risk Manager reports to the CEO and will be a critical point-of-contact for employees, senior leadership, and regulatory agencies. 

Weiser Memorial Hospital, a PERSI employer, offers a competitive benefits package in addition to continuing education and professional development opportunities. Benefits include, but are not limited to: 

• Idaho State Retirement (PERSI)
• 401(k)
• Medical, dental, and vision insurance plans
• Discounted medical services
• Medical and dependent care savings plans
• Guaranteed life insurance
• Employee Assistance Program
• Voluntary Air St. Luke's Membership

Weiser Memorial Hospital participates in E-Verify and is an Equal Opportunity Employer. 

Weiser, ID, is located in Western Idaho, minutes away from I-84 and offers a lower cost of living than the national average, including nearby Boise. Weiser is well-known for its many rivers, access to outdoor recreational areas, and as the host of the annual National Old-time Fiddlers' Contest & Festival. 

Responsibilities

QUALITY

1. Develops and coordinates processes to monitor quality of care. Identifies opportunities to improve patient care, treatment, and services. 

2. Maintains administrative control of data/database related to the facility's performance improvement program. 

3. Develops and maintains scorecards and dashboards. 

4. Conducts internal audits, develops action plans, and outlines projects. 

5. Facilitates performance improvement efforts in service areas to respond to and act on patient experience data. 

6. Assists in the collection and evaluation of medical record information and provides communication with the members of the healthcare team. 

7. Facilitates performance improvement and quality performance improvement “QAPI” activities throughout the hospital.

8. Participates on select committees including, but not limited to: Patient Safety, Infection Control, and others as may be assigned.

9. Demonstrates effective organizational skills through ongoing interaction with nurse managers, ancillary department managers, administrative team, Governing Body and, as needed with clinicians, to facilitate the hospital wide continuous performance improvement program. 

RISK

1. Administers the risk management program activities on a day-to-day basis, managing and analyzing risk management data, complying with risk management regulatory standards; all with the objective of maintaining patient safety, enhancing quality, and minimizing loss to protect the assets of the facility.

2. Initiates medical record review for the purpose of identification of real or potential risk and the monitoring of documentation practices.

3. Collaborates with senior leadership to establish and quantify the organization’s 'risk appetite', i.e., the level of risk they are prepared to accept.

4. Ability to carry out processes such as purchasing insurance, implementing health and safety measures, and making business continuity plans to limit risks and prepare for if things go wrong.

5. Interacts professionally with patient/family to increase patient/family satisfaction and/or diffuse potential litigious occurrences related to patient/family perception.

6. Manages risk management, performance improvement, and patient relations information as needed for administrative activities, credentialing, and hospital insurers.

7. Investigates and analyzes actual and potential risks in the organization; assesses liability and probability of legal action for potential notification of insurance carriers.

8. Liaisons with attorneys for claims reviews, discovery and coordinates interviews, site visits, and depositions.

9. Reviews incident reports and assists with oversight of incident reporting system. Performs statistical analysis and creates reports on trending of events and leads the proactive assessment and develops mitigation and sustainable strategies for clinical risk vulnerabilities. 

COMPLIANCE

1. Supervise the implementation and maintenance of the hospital’s compliance program to ensure that all facility activities and operations are carried out in compliance with local, state, and federal regulations, CAH standards and laws governing healthcare operations.

2. Participate in the development of guidelines concerning state and federal regulations regarding ethical and legal business practices. Stay current with changes in state and federal laws, regulations, and policies, and incorporate these changes into the compliance program.

3. Reviews the compliance program on an annual basis and makes any updates, modifications, or revisions in the plan.

4. Monitors the issuance of fraud alerts by the Office of the Inspector General of the Department of Health and Human Services.

5. Assures that all personnel receive training and education in the basic principles of compliance and ethical business practices.

6. Plans and oversees audits of the hospital’s compliance program to identify any problems and provide resolution of any problems to ensure the efficacy of the program.

7. Ensures all outside contractors and agents are aware of the hospital’s compliance program regarding billing, coding, kickbacks, marketing, and referrals.

8. Implements and maintains the Compliance Hotline.

Requirements

• Bachelor’s degree in Nursing, Healthcare Administration, or other Healthcare related field required. 
• 3 years’ experience in quality/risk management preferred.
• Demonstrated ability in creating reports, utilizing statistical concepts and measures.
• Proven skills utilizing a variety of computer software applications: i.e., SharePoint, spreadsheets, databases, word processing and presentations.
• Knowledge about ICD-10 and CPT coding as they relate to data stratification/analysis and reimbursement issues.
• Knowledge of and the ability to apply the principles of health information management and change management.
• Demonstrated success in working cooperatively with diverse personalities under demanding circumstances and with rapidly changing priorities.
• Related education and experience in statistical and data analysis, data management and the ability to present and explain results to various audiences.
• Excellent written and verbal communication skills.
• Demonstrated knowledge of information privacy and confidentiality laws and standards.
• Officer of Healthcare Compliance Certified (OHCC) or other accepted certification.  Required within one (1) year.
• Certified Professional in Healthcare Quality (CPHQ) and successful completion of ISO implementation course or equivalent preferred. Required within one (1) year.