Director, Quality

Lifepoint Health • Waukesha, WI

65d

About The Position

At Rehabilitation Hospital of Wisconsin , we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you’ll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve.
Director of Quality Position Summary
Leads and oversees a comprehensive, efficient, and integrated hospital-wide Continuous Quality and Performance Improvement (CQPI) program. Uses data collection, analysis, and trending to assess performance; focuses on process and systems improvement; directs risk management and patient safety activities; investigates adverse outcomes; coordinates regulatory/accreditation readiness; and educates staff on CQPI and related quality programs.

Requirements

• Licensure: Registered Nurse with current state licensure highly preferred; clinical license required.
• Education: BSN or BS/BA required.
• Experience: Minimum two (2) years in an acute hospital or rehabilitation setting required
• Certifications: Basic Life Support (BLS/CPR) required; certification preferred by APIC (American Practitioners of Infection Control) and NAHCQ (National Association of Health Care Quality).
• Skills: Data analysis and reporting; CQPI methodologies (e.g., RCA, FMEA, PDSA); risk management and patient safety facilitation; regulatory/accreditation readiness; effective teaching, communication, and collaboration.

Nice To Haves

• prior supervisory experience preferred.
• certification preferred by APIC (American Practitioners of Infection Control) and NAHCQ (National Association of Health Care Quality).

Responsibilities

• Provide leadership and oversight of the organization-wide CQPI program.
• Measure and assess performance by collecting, analyzing, and trending data to identify opportunities for improvement.
• Focus on improving processes and systems to drive clinical quality, safety, and operational performance.
• Direct, facilitate, and report on all aspects of risk management and patient safety.
• Investigate factors contributing to adverse outcomes and drive process/system changes.
• Direct the hospital-wide CQPI operations, including record reviews for quality indicators and reporting findings to leadership, Medical Executive Committee, Board of Managers, and other committees.
• Annually review hospital-wide plans for Infection Control (IC) and CQPI; establish goals and objectives for the coming year.
• Serve as liaison to local health officials; coordinate inspections and accreditation reviews with state and other regulatory agencies.
• Develops and delivers hospital-wide CQPI education and training.
• Prepares quality/patient safety reports and dashboards for leaders and committees.
• Partners with clinical and non-clinical departments to sustain improvements and ensure compliance with applicable standards.
• Perform other duties as assigned.

Benefits

• Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
• Competitive Paid Time Off
• Employee Assistance Program – mental, physical, and financial wellness assistance
• Tuition Reimbursement/Assistance for qualified applicants

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 101-250 employees