Compliance PI Director

Wellpath•Fresno, CA

About The Position

The Compliance and Performance Improvement Director is responsible for management and administration of facility’s quality and performance improvement activities and also supervises the Medical Records Department. Overall responsibilities include providing technical assistance to facility leaders for the development and implementation of processes and systems to deliver safe and quality care and services that comply with licensing and regulatory standards, coordinating data collection, tracking and trending, and the monitoring of performance indicators.

Requirements

A Bachelor’s degree in human services, healthcare field, management, or LVN Licensure required.
Three (3) years of experience in a performance improvement, quality assurance, or contract management related position.
Experience in healthcare, correctional, security, forensic facility or secure setting preferred.
Demonstrated experience in performing tasks related to process design, management and improvement; systems analysis; data collection, analysis and reporting; and other tasks requiring general management and leadership skills may be substituted on a year for year basis for experience in a direct performance improvement, quality assurance, or contract management position.
Excellent written, verbal, and computer skills.
Experience with Microsoft Office, especially Excel, required.

Nice To Haves

Master’s Degree preferred.
Experience working with accreditation or regulatory standards desirable.
Experience with Six Sigma or LEAN process improvement methodologies desirable.
Experience with data analysis software desirable.
CPHQ, Six Sigma or other quality professional certification preferred.

Responsibilities

Lead facility-wide performance improvement and patient safety initiatives using data-driven methods to achieve best-practice clinical outcomes and reduce medical errors, adverse events, and serious injuries.
Ensure regulatory, contractual, and accreditation compliance through oversight of internal audits, inspections, self-assessments, corrective action plans, and coordination with external regulatory and accreditation bodies.
Analyze, monitor, and report performance indicators and incidents, including trend analysis, root cause investigations, mortality and morbidity reviews, and concise executive-level reporting.
Provide leadership, supervision, and training, including direct supervision of the Medical Records Department and education of staff and leadership on performance improvement tools, data analysis, and continuous improvement methods.
Support facility leadership and stakeholder engagement through policy and program development, satisfaction surveys, investigations, liaison activities, and other assigned duties.