Quality and Safety Oversight Specialist IV (KFH/HP)

Kaiser Permanente-posted 4 months ago
Honolulu, HI
Ambulatory Health Care Services
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Contributes to developing quality strategies in alignment with KFHP strategic priorities, mission, and vision. Coordinates and collaborates across areas to recommend actions based on reviews of regional quality reports. Identifies opportunities for improvement and helps establish priorities. Contributes to recommending actions to senior leadership to improve clinical quality. Helps determine accountability and ensure quality issues are identified and resolved. Acts as a subject matter expert for clinical quality processes and regulations within a specified area to review and act on results of data analysis, monitor corrective action plans, and review and approve quality policies. Facilitates the oversight of and coordination with the functions of Quality Committees and subcommittees. Contributes to the annual approval of Quality Program description, work plans, and annual evaluations.

  • Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members.
  • Builds relationships with cross-functional/external stakeholders and customers.
  • Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers.
  • Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses.
  • Leads by influencing others through technical explanations and examples and provides options and recommendations.
  • Adopts new responsibilities; adapts to and learns from change, challenges, and feedback.
  • Demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes.
  • Facilitates team collaboration to support a business outcome.
  • Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions.
  • Encourages team members to adapt to and follow all procedures and policies.
  • Collaborates cross-functionally and/or externally to achieve effective business decisions.
  • Provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate.
  • Monitors progress and results.
  • Supports the development of work plans to meet business priorities and deadlines.
  • Identifies resources to accomplish priorities and deadlines.
  • Identifies, speaks up, and capitalizes on improvement opportunities across teams.
  • Uses influence to guide others and engages stakeholders to achieve appropriate solutions.
  • Serves as the subject matter expert for clinical quality improvement processes and regulations within assigned departments.
  • Maintains awareness of current internal policies and external regulations.
  • Participates on committees, projects to propose a course of action on the enforcement, development of policies or procedures of regulations and auditing processes.
  • Maintains collaborative, results oriented partnerships with practitioners and/or staff across clinical and administrative roles to ensure compliance with regulations and improve patient safety, reporting accuracy, and health outcomes.
  • Delivers educational programs to raise awareness for regulation requirement, internal concerns, and system/database usage.
  • Anticipates issues, weighs practical considerations in addressing issues, and seeks input from engagement manager/sponsor to resolve.
  • Facilitates quality of care complaints and the review process.
  • Participates in grievance meetings, cases, reviews, referrals, or other mechanisms as needed.
  • Makes recommendations based on available evidence and assessing if the quality of care complaint can be substantiated.
  • Proactively coordinates with the appropriate individuals/teams to ensure the quality of care concern is referred to the right team.
  • Monitors the process flow of investigations and claims as requested.
  • Monitors cases, quality care incidents, and near misses according to established protocols on an ongoing basis.
  • Delivers infection prevention and control programs to improve employee and patient safety.
  • Conducts epidemiological research as a part of prevention and surveillance, outbreak management as requested.
  • Adheres to outbreak protocols and leads all outbreak containment efforts within the area of focus.
  • Facilitates clinical quality improvement oversight risk management efforts.
  • Assists with the development of corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials, patient satisfaction surveys, and auditing surveys.
  • Conducts root cause analysis, failure mode and effect analysis, and other assessments in response to significant events, near misses, and good catches in order to identify areas of improvement.
  • Assists with escalating high-risk issues and trends to appropriate entity for resolutions.
  • Utilizes health outcome analysis to continuously monitor oversight effectiveness.
  • Delivers patient safety and satisfaction programs and initiatives.
  • Identifies and resolves safety hazards, accidents, incidents, threats, and significant events promptly.
  • Delivers patient care and satisfaction programs which aim to improve patient flow, clinical support, patient services, and seamless transition of care.
  • Develops new clinical quality improvement programs.
  • Consults with practicians, teams, and departments to develop guidelines, metrics, and operational definitions of quality improvement.
  • Analyzes program performance, and peer/department review groups.
  • Integrates continuous learning orientation into programs to assist with oversight, development, and improvement initiatives.
  • Enters and reports data from systems, procedures, and forms to improve data management programs.
  • Conducts descriptive and inferential statistical analysis for complex quality improvement evaluations.
  • Analyzes data from databases, vital statistics, hospital patient discharge data, claims, and other relevant health sources.
  • Prepares and presents reports into specified formats within assigned area.
  • Conducts regulatory audits and surveys.
  • Coordinates with departments and external representatives for onsite visits and evaluations.
  • Delivers requested routine and ad hoc audit documentation, information, reports, and tools throughout the auditing process.
  • Coordinates with practitioners and employees within designated departments to ensure the completion of required auditing surveys.
  • Coordinates within assigned areas to evaluate the cost effectiveness, practicality, appropriateness, and equal application of care to diverse patients.
  • Minimum one (1) year of experience in a leadership role with or without direct reports.
  • Minimum two (2) years of experience with databases and spreadsheets.
  • Minimum two (2) years of experience delivering training programs.
  • Minimum two (2) years of experience in clinical setting, health care administration, or a directly related field.
  • Bachelor's degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field AND Minimum three (3) years of health care experience or a directly related field OR Minimum six (6) years of experience in health care or a directly related field.
  • Knowledge of Compliance Management.
  • Health Care Data Analytics.
  • Learning Measurement.
  • Managing Diverse Relationships.
  • Delegation.
  • Project Management.
  • Health Care Quality Standards.
  • Quality Improvement.
  • Quality Assurance and Effectiveness.
  • Evidence-Based Medicine Principles.
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