Transplant QAPI Supervisor

Beth Israel Lahey Health•Boston, MA

About The Position

Reporting to the Transplant QAPI & Regulatory Manager, the Quality Assurance Performance Improvement (QAPI) Supervisor supports the Transplant Program in maintaining compliance with Centers for Medicare & Medicaid Services (CMS) Conditions of Participation and Organ Procurement and Transplantation Network (OPTN) requirements. This role partners with multidisciplinary teams across transplant programs to lead, coordinate, and operationalize a comprehensive, data-driven QAPI program focused on patient safety, regulatory compliance, and continuous performance improvement.

Requirements

Vaccination against influenza (flu) as a condition of employment.

Responsibilities

Working with Co- Medical Directors of the QAPI committee - prepare meeting agenda, maintain meeting minute, coordinate follow-up/action items, prepare annual Hospital Presentation.
Maintain knowledge of CMS QAPI requirements, coordinate implementation of changes.
Provide data on key indicators as determined by Committee to identify areas for improvement.
Collaborate with team leader improvement project to provide data, suggest methods for analysis, prepare presentations.
Maintain log of activity for CMS survey.
Centralize and improve compliance by serving as liaison with all donation and transplant-related regulatory agencies, including CMS, UNOS, JCAHO, and others.
Provides documentation and assistance for all regulatory audits (on-site or desk audits).
Assist in the preparation and ongoing monitoring of action plans in response to regulatory surveys.
Develop and manage Transplant Center's work plan to achieve constant readiness for regulatory site visits and surveys.
Coordinate patient and Transplant Center information and data submissions to various regulatory agencies as required.
Design and deliver education for all Transplant Center staff on compliance with new and revised guidelines and regulations.
In collaboration with transplantation leadership, manages the development and monitors implementation and maintenance of transplant policies and protocols.
Active participant in root cause analysis of sentinel events that occur within the Transplant Program.
Communicate events and findings with Transplant Institute leadership and appropriate staff.
Work with Contracting on the completion of the UNOS and various RFIs for Insurers.
Work collaboratively with the database manager on data collection improvement projects