Risk & Quality Assurance Specialist | Full-Time | South Portland, ME

InterMed PA • South Portland, ME

5d

About The Position

CORE RESPONSIBILITIES: Risk Management, Patient Safety and Patient Experience · Support the identification, evaluation, and mitigation of risks related to patient safety, clinical care, and regulatory compliance to protect patients and reduce liability within the organizations. · Manage the investigation of adverse patient outcomes, quality of care opportunities and patient safety events to assess potential harm, identify root causes, and coordinate appropriate follow-up actions, as assigned by the department Director. · Identify and escalate adverse events, complaints and grievances that may lead to potential claims in a timely manner. · Manage the investigation of verbal and written complaints and grievances involving quality of medical care and services. · Independently research of medical records, interviews with involved parties, documentation of findings, formulation of responses, and facilitation of resolution whenever possible. · Apply techniques of problem solving, active listening, negotiation, conflict resolution, diplomacy, and diffusion of emotions in investigating and addressing adverse events, complaints and grievances. · Negotiate and mitigate expectations to promote satisfaction, ensure quality and safety and minimize the risk of adversarial outcomes. · Provide planned, as well as just in time, education related to customer service, conflict resolution, and effective tools for establishing interpersonal connections with patients and families. · Support the development and implementation of standard operating procedures related to risk management, patient safety and quality assurance. · Partner with clinical and operational leaders, the ASC directors and care teams to embed safety and risk mitigation strategies into workflows. · Support development of a safe and just culture by supporting frontline staff and clinical leaders in safety reporting and response efforts. · Support the facilitation of safety and risk education for clinical and administrative staff, including orientation and ongoing training. · Review and report on patient experience measures. · Develop and support implementation of performance improvement plans related to patient experience measures. · Benchmark performance against industry standards and best practices. Ambulatory Surgical Center (ASC) Risk Management and Quality Assurance Support · Support the development and execution of ASC Quality Assurance and Performance Improvement (QAPI) Program Annually. · Support the development and execution of the ASC Risk Management Program Annually. · Assist in tracking and reporting required measures as outlined in the Medicare Ambulatory Surgical Center Quality Reporting (ASCQR) program. · Assist in conducting medical record reviews in alignment with the ASC policies to ensure ongoing compliance with documentation requirements. · Participates in activities that support ongoing readiness for regulatory and accreditation surveys. Quality Assurance · Assist in the development and implementation of quality improvement initiatives to enhance patient outcomes and operational efficiency. · Collaborate with healthcare teams to promote evidence-based practices and continuous improvement. · Maintain current knowledge of healthcare regulations, accreditation standards, and industry trends. · Assist in the creation and implementation of quality management systems to support consistent and safe clinical practices. · Support operational teams to ensure provision of safety patient care and risk mitigation. · Maintains strict confidentiality in alignment with HIPAA (Health Insurance Portability and Accountability) guidelines and InterMed policies. · Perform other duties to support the mission, vision and values of InterMed. MISSION AND VALUES: · Follows InterMed's mission to provide patient-centered primary care, putting the patient first to deliver high quality, high value care. · Provide the highest quality care to our patients with a level of service that exceeds their expectations. · Maintain a positive attitude and always treat our patients and each other with dignity and respect. · Insist on honesty and integrity from each other and our business partners. · Make teamwork a core component of our relationships between physicians, staff, and patients. · Embrace change to better serve our patients. · Use business practices that feature individual accountability and group responsibility to ensure delivery of high value healthcare. · Have fun as we carry out our mission to serve.

Requirements

• Bachelor's degree in healthcare administration or equivalent combination of experience and education required
• 3-5 years healthcare, clinical quality, patient safety, and/or risk management experience required
• Certified Professional in Healthcare Risk Management (CPHRM) or Certified Professional in Patient Safety (CPPS) required, or ability to obtain certification within 1 year of hire.

Nice To Haves

• Active unencumbered Registered Nurse (RN) license in Maine preferred

Responsibilities

• Support the identification, evaluation, and mitigation of risks related to patient safety, clinical care, and regulatory compliance to protect patients and reduce liability within the organizations.
• Manage the investigation of adverse patient outcomes, quality of care opportunities and patient safety events to assess potential harm, identify root causes, and coordinate appropriate follow-up actions, as assigned by the department Director.
• Identify and escalate adverse events, complaints and grievances that may lead to potential claims in a timely manner.
• Manage the investigation of verbal and written complaints and grievances involving quality of medical care and services.
• Independently research of medical records, interviews with involved parties, documentation of findings, formulation of responses, and facilitation of resolution whenever possible.
• Apply techniques of problem solving, active listening, negotiation, conflict resolution, diplomacy, and diffusion of emotions in investigating and addressing adverse events, complaints and grievances.
• Negotiate and mitigate expectations to promote satisfaction, ensure quality and safety and minimize the risk of adversarial outcomes.
• Provide planned, as well as just in time, education related to customer service, conflict resolution, and effective tools for establishing interpersonal connections with patients and families.
• Support the development and implementation of standard operating procedures related to risk management, patient safety and quality assurance.
• Partner with clinical and operational leaders, the ASC directors and care teams to embed safety and risk mitigation strategies into workflows.
• Support development of a safe and just culture by supporting frontline staff and clinical leaders in safety reporting and response efforts.
• Support the facilitation of safety and risk education for clinical and administrative staff, including orientation and ongoing training.
• Review and report on patient experience measures.
• Develop and support implementation of performance improvement plans related to patient experience measures.
• Benchmark performance against industry standards and best practices.
• Support the development and execution of ASC Quality Assurance and Performance Improvement (QAPI) Program Annually.
• Support the development and execution of the ASC Risk Management Program Annually.
• Assist in tracking and reporting required measures as outlined in the Medicare Ambulatory Surgical Center Quality Reporting (ASCQR) program.
• Assist in conducting medical record reviews in alignment with the ASC policies to ensure ongoing compliance with documentation requirements.
• Participates in activities that support ongoing readiness for regulatory and accreditation surveys.
• Assist in the development and implementation of quality improvement initiatives to enhance patient outcomes and operational efficiency.
• Collaborate with healthcare teams to promote evidence-based practices and continuous improvement.
• Maintain current knowledge of healthcare regulations, accreditation standards, and industry trends.
• Assist in the creation and implementation of quality management systems to support consistent and safe clinical practices.
• Support operational teams to ensure provision of safety patient care and risk mitigation.
• Maintains strict confidentiality in alignment with HIPAA (Health Insurance Portability and Accountability) guidelines and InterMed policies.
• Perform other duties to support the mission, vision and values of InterMed.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees