Manager of Clinical Risk and Quality Improvement

Fair Haven Community Health Care•New Haven, CT

About The Position

Fair Haven Community Health Care (FHCHC) is seeking a Manager of Clinical Risk and Quality Improvement to manage the day-to-day operations of the organization’s clinical risk mitigation and quality improvement analysis. This role ensures continuous compliance with Federal Tort Claims Act (FTCA) deeming standards and HRSA Health Center Program requirements. The manager identifies clinical vulnerabilities through formal assessments and collaborates with the Data and Analytics Department to interpret dashboards and lead performance improvement projects. FHCHC has been an innovative and vibrant community health center for over 54 years, serving multiple generations with over 165,000 office visits across 21 locations. Guided by a Board of Directors, most of whom are patients themselves, FHCHC takes pride in being a healthcare leader dedicated to delivering high-quality, affordable medical and dental care to everyone, regardless of their insurance status or ability to pay. Their extensive range of primary and specialty care services, along with evidence-based programs, empowers patients to make informed choices about their health. As they expand their reach to underserved areas, their commitment to prioritizing patient needs remains unwavering. FHCHC's mission is to enhance the health and social well-being of the communities they serve through equitable, high-quality, and culturally responsive patient-centered care.

Requirements

Bachelors’ degree required
At least 5 years of professional experience required
Excellent communication (verbal, written, and presentation) skills
Strong project management skills managing complex, multifaceted projects resulting in measurable successes and program growth
Quality improvement, systems change, and policy development skills
Strong analytic skills; experience mining an EHR for required data
Demonstrated knowledge of federal and state regulations

Nice To Haves

Graduate degree in nursing, public health, or other relevant field is preferred

Responsibilities

Leads the technical data collection and administrative assembly of the Risk Management and Credentialing and Privileging (C&P) sections of the annual FTCA deeming and redeeming applications to ensure all submissions meet HRSA/BPHC standards.
Executes comprehensive annual clinical risk assessments across all departments to identify vulnerabilities and satisfy federal requirements.
Facilitates investigations into clinical incidents and “near misses,” leading Root Cause Analysis (RCA) in collaboration with clinical leadership.
Oversees the formal grievance process, ensuring systemic issues are identified and addressed to mitigate organizational liability.
Synthesizes clinical risk data into high-level reports for the CCO, CMO, and the Board of Directors to guide strategic decision-making.
Coordinate the Risk Management Committee, including agenda preparation and minute-taking.
Monitors the overall compliance of the Credentialing & Privileging system, ensuring that processes for Licensed Independent Practitioners (LIPs), Other Licensed or Certified Practitioners (OLCPs), and Other Clinical Staff (OCSs) meet HRSA standards.
Conducts periodic audits of credentialing files and tracking systems to ensure primary source verification and fitness for duty are documented correctly by the Credentialing Manager.
Monitors the administrative framework for Focused Professional Practice Evaluations (FPPE) and Ongoing Professional Practice Evaluations (OPPE) to ensure timely completion.
Provides analyzed clinical data and evidence-based findings to the CCO to support their reporting to the QIC and the Board of Directors.
Partners with the Data and Analytics Department to review generated dashboards, identifying trends and opportunities for clinical performance improvement.
Designs and executes targeted QI projects based on FTCA, The Joint Commission Ambulatory Care and PCMH requirements, and clinical outcomes.
Facilitates the “Plan-Do-Study-Act” (PDSA) cycle for clinical teams and provides “just-in-time” coaching on QI methodologies.
Maintains clinical documentation for The Joint Commission (TJC) and NCQA PCMH status to ensure workflows meet patient safety standards.
Designs and implements the annual clinical risk and privacy training plan for all staff to satisfy mandatory FTCA requirements.
Conducts educational sessions for clinical and administrative staff on risk reduction and regulatory compliance.
Leads the drafting and periodic revision of clinical risk policies to reflect current regulatory changes and internal audit outcomes.