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Clinical Quality Director (1285206)

In addition to the responsibilities listed above, this position is also responsible for consulting with the Board of Directors and providing strategic direction on the oversight of systems designed to monitor and ensure the quality care and services are provided at a comparable level to all members and patients across the continuum of care; alleviating or resolving issues in quality improvement systems; aligning and directing others on resolving issues related to the organization meeting the standards established by regulatory agencies and accreditation organizations and meeting public expectations; communicating and championing best practices for maintaining the integrity of systems related to the selection, credentialing and competence of physicians and other health care practitioners; driving the implementation of systems for granting or terminating clinical privileges, professional staff or medical staff or clinical staff membership, proctoring and continuing education; championing the use of standardized and established processes for reviewing and approving medical staff or provider staff Bylaws, Rules and Regulations and amendments; and serving as a liaison for the oversight of systems of all contracted entities including but not limited to the Permanente Medical Groups. This role is also responsible for championing the peer review process, committees, and forums to evaluate and ensure hospital or health system performance; developing strategic insights and guidance based on preliminary and comprehensive feedback; and defining and driving a strategic development plan to address needs and solve problems.

Essential Responsibilities:

Area Quality Leader

In addition to the responsibilities listed below, this position is also responsible for providing strategic oversight and guidance to large-sized service areas (i.e., facilities with more than 300 licensed beds) by leading the development and implementation of broad, complex quality programs and initiatives; serving as a leader and expert on clinical quality management programs and initiatives; proactively monitoring performance metrics and performance improvement activities across large, complex services lines and facilities; championing and overseeing the use of evidence-based guidelines and criteria to optimize clinical outcomes; directing accreditation, licensing, and regulatory activities and ensuring compliance in all applicable settings, including compliance with administrative, legal, and regulatory requirements; partnering with and directing medical staff in large service areas to support peer review, practitioner performance review, and oversight processes across broad, complex services lines and facilities; and developing, evaluating, and managing ongoing improvement systems to reduce care delivery risk and medical errors across broad, complex services lines and facilities.

Essential Responsibilities:

Health Plan Quality & Performance Improvement Director

Focused on government programs, Medicaid, Medicare quality. Contributes to strategic planning for a broad range of administrative, facilitation, and technical support functions in the area of Quality and Safety Improvement to support Quality and Safety programs and initiatives. Oversees and directs the development, implementation, monitoring, and continuous improvement of Quality and Safety programs and initiatives. Directs teams by defining the standards to develop and monitor performance indicators and metrics, synthesizes data from multiple reporting systems and sources to identify opportunities to improve quality and safety, decrease risk, and maintain the KP safety culture. Develops and coordinates across the organization to define the standards to identify priority issues related to quality and safety.

Essential Responsibilities:

Achieving Excellence with Value-Based Care: Cedar-Sinai Orthopaedic Superbundles Report

Since January 2021, Cedars-Sinai Medical Center has participated in the Orthopaedic Bundled Payments for Care Improvement Advanced (BPCI-A) Medicare Superbundle. To maintain quality while improving value metrics, the Ortho team examined all aspects of the 90-day episode-of-care for ortho trauma and elective joint replacements. We found that multidisciplinary coordination and collaboration are vital for outstanding […]

Tube Transport: Evolution and Prospects in Blood Banking and Transfusion Medicine

Pneumatic tube systems have been used for years as an effective way to transport items, including blood bank specimens and products. This presentation will explore this oft underappreciated technology and discuss various aspects of its use in blood bank/transfusion medicine. Join us as we review how pneumatic tubes can impact patient care and how sending things “down the tubes” can change workflows.

Q4 2023 Hospital In-Patient Signal Detection Report

About HQI’s Sentinel Signal Detection System Report HQI’s sentinel signal detection system automatically detects abnormal changes (i.e., signals) in the incidence of diagnosis categories from hospital encounter records in the Hospital Quality Improvement Platform (HQIP). Every quarter, HQI aggregates these signals across reporting hospitals to provide a statewide perspective. In the Q4 2023 Inpatient Signal Detection […]

Unlocking Health Data for Better Care: The Role of QHIOs in CalAIM and Quality Initiatives

Qualified Health Information Organizations (QHIOs) go beyond technical milestones to embody digital equity. They function as essential health data utilities, serving historically marginalized entities including healthcare providers, health plans, Medicaid agencies, and public health departments. Through processing and analyzing extensive health data, QHIOs identify trends, enhance care quality, and support public health initiatives. As we […]