Supports a broad range of administrative, facilitation, and technical support functions in the area of Quality and Safety Improvement. Supports the development, implementation, and monitoring of Quality and Safety programs and initiatives. Supports the development of performance indicators and metrics, collaborates with others to collect, analyze, and trend data from multiple reporting systems and sources to identify opportunities to improve quality and safety, decrease risk, and maintain the KP... more details
Description:
Job Summary:
Supports a broad range of administrative, facilitation, and technical support functions in the area of Quality and Safety Improvement. Supports the development, implementation, and monitoring of Quality and Safety programs and initiatives. Supports the development of performance indicators and metrics, collaborates with others to collect, analyze, and trend data from multiple reporting systems and sources to identify opportunities to improve quality and safety, decrease risk, and maintain the KP safety culture. Coordinates with others to support priority issues related to quality and safety. Is learning to act as a resource for issues related to quality and safety. Supports the organizations compliance with professional standards, laws and regulations, and internal requirements related to quality and safety.
Essential Responsibilities:
Pursues effective relationships with others by sharing resources, information, and knowledge with coworkers and members. Listens to, addresses, and seeks performance feedback. Pursues self-development; acknowledges strengths and weaknesses based on career goals and takes appropriate development action to leverage / improve them. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work. Assesses and responds to the needs of others to support a business outcome.
Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; follows procedures and policies, and applies data and resources to support projects or initiatives with limited guidance and/or sponsorship. Collaborates with others to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports the completion of priorities, deadlines, and expectations. Identifies and speaks up for ways to address improvement opportunities.
Supports data extraction, analyses, and presentations to support quality improvement efforts with minimal guidance from more senior team members by: conducting descriptive and inferential statistics for quality improvement evaluations; assembling information to create charts and graphs of improvements utilizing multiple data reporting systems; preparing quality improvement metric reports to demonstrate improvements and effectiveness of quality improvement programs into specified formats; and assisting with the identification and documentation of trends, potential errors, and other analysis for further review.
Supports quality improvement and improvement risk management efforts by: assisting with the development of corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials, member satisfaction surveys, and auditing surveys; ensuring process improvements are compliant with established internal regulation requirements; supporting root cause analysis as requested; supporting failure mode and effects analysis for newly internalized processes and programs as requested; and assisting with escalating small risk issues and trends to appropriate entity for resolutions.
Develops and supports the utilization of quality improvement performance metrics by: maintaining performance metrics, standards, and methods to establish improvement success; collaborating with multiple stakeholders, often with competing/conflicting objectives, to ensure development of cohesive and reachable metrics as directed; and assisting with assigned initiatives to ensure delivery of measurable results and alignment with strategic objectives.
Assists in the development of quality improvement initiatives by: leveraging appropriate methods and tools to develop stakeholders capabilities for process improvements; applying data-driven improvement principles, tools, and problem-solving methods, and techniques using quality improvement metrics with guidance from senior team members; and assisting in the creation of milestones, detailed workplans, and documentation practices.
Serves as the subject matter expert for quality improvement processes and regulations within assigned area by: learning current internal policies and external regulations; supporting collaborative, results oriented partnerships to ensure compliance with regulations and improve patient safety, maintain the KP safety culture, reporting accuracy, and health outcomes; preparing materials for educational programs to raise awareness for regulation requirement, internal concerns, and system/database usage; and supporting internal quality improvement committees and projects as requested.
Assists in stakeholder development and quality performance review efforts by: coordinating utilization and performance reviews utilizing multidisciplinary criteria and guidelines, and takes a systematic approach to quality improvement; escalating performance areas of improvement for stakeholders; and developing and preparing materials for training and educational programs related to process improvement for quality improvement programs for stakeholders.
Minimum Qualifications:
Minimum one (1) year of experience with databases and spreadsheets or continuous quality improvement (CQI) tools.
Bachelors degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field AND Minimum one (1) year of experience in quality, performance improvement, customer service, or a related field OR Minimum four (4) years of experience in heath care quality assurance/improvement or a directly related field.
Additional Requirements:
Knowledge, Skills, and Abilities (KSAs): Applied Data Analysis; Quality Improvement; Development Planning; Agile Methodologies; Risk Assessment
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