Organizational Quality Manager

Provides leadership for Bryan Health's quality-compliance and measurement programs, requirements, and organizational quality professionals. Responsible for a planned, systemic approach for design, adoption, measurement, and continuous improvement of the quality management system as part of the Bryan Health Improvement System. Collaborates with providers and staff throughout the organization to develop sustainable capability to exceed industry standards for regulatory/quality compliance and benchmarks for publicly reported outcomes. Leads key functions of accreditation, regulatory quality measurement, value-based programs, process change control, quality outcomes analysis, and other initiatives for improving quality performance through a culture of safety and continuous improvement.

PRINCIPAL JOB FUNCTIONS:

1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.

2. *Functions as Manager for area of responsibility, aligning team objectives with the organization, recruiting and managing staff performance/ development, and managing department capital and expense budgets according to organizational values, policies and guidelines.

3. *Leads the adoption and sustainment of the Bryan Health Improvement system in area of responsibility to achieve service excellence, sustainable capability, and a culture of continuous improvement.

4. *Supports system-wide regulatory, accreditation, and contracted compliance requirements, survey readiness and timely resolution of corrective/improvement actions.

5. *Maintains current knowledge of applicable accreditation, compliance, and contracted agency/program and industry standards, and monitors advancements to ensure organizational adoption and compliance.

6. *Leads or participates in governance groups and improvement initiatives or teams as assigned.

7. *Manages the required clinical data retrieval, analysis, and submission to external agencies and promoting interoperability program.

8. *Facilitates the use of statistical and other analytic methods to analyze and inform decisions and validation of outcomes for quality improvement teams/projects and governance groups.

9. *Oversees the benchmarking of quality and patient safety measures against internal and external groups.

10. *Manages system-wide process for controlled document management (procedures) and process change control.

11. *Consults with divisions, services lines and teams for the identification, improvement, and sustainment of quality and patient safety opportunities, compliance requirements, measures, and internal standards.

12. *Collaborates across the organization to maintain an effective data governance lifecycle and data analytics capabilities that support effective operations and improvement.

13. Supports the development and maintenance of internal standards (procedures, order sets, work instructions.)

14. Assists in the development, implementation, and ongoing assessment of the quality and safety plan.

15. Participates in product/software evaluation studies and consequent decision-making activities.

16. Supports the identification, validation and effective spread of locally proven system capability.

17. Develops & delivers training and information to the organization on quality-related topics.

18. Develops communication plans and communicates extensively with key stakeholders; crafts messages, presentations and reports tailored to the appropriate target audience and desired outcome.

19. Advances work knowledge by participation in professional development and educational activities.

20. Performs other related duties as assigned.

(Essential Job functions are marked with an asterisk "*". Refer to the Job Description Guide for the definition of essential and non-essential job functions.) Attach Addendum for positions with slightly different roles or work-specific differences as needed.

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

1. Knowledge of the health care industry, clinical roles and processes, regulations and accreditations, payers, revenue cycle, medical and pharmacological terminology, and health system structure.

2. Knowledge of healthcare performance measures/objectives and value-based programs.

3. Knowledge of equipment, supplies, electronic health records and other software used in a health care environment and relevant to work functions.

4. Knowledge of the principles and methods of improvement science, data governance, and data analysis

5. Skill in change management and conflict resolution.

6. Skill in advanced use of the Microsoft Office suite.

7. Ability to facilitate effective system and process analyses, data analysis, and scientific improvement cycles.

8. Ability to communicate effectively in both written and oral forms, including large group presentations.

9. Ability to lead, facilitate, or participate in cross-functional teams/groups.

10. Ability to develop and conduct effective educational programs.

11. Ability to manage effective working relationships with employees, leaders, medical staff, customers, external compliance representatives, and stakeholders.

12. Ability to interpret healthcare-related statutes, standards, contracts, and technical specifications.

13. Ability to recruit/hire, manage performance, and develop professional staff.

14. Ability to maintain regular and punctual attendance.

15. Ability to manage multiple responsibilities effectively, with minimal supervision in a dynamic environment.

16. Ability to maintain confidentiality relevant to sensitive information.

EDUCATION AND EXPERIENCE:

Bachelor's degree in nursing, allied health, business, engineering or related field required. Master's degree preferred. Minimum of five (5) years of progressive experience in quality, OR performance improvement, OR clinical care/operations required. Minimum of two (2) years of supervisory OR program management experience required. Advanced analytical skills strongly preferred. Experience with regulatory surveys and compliance strongly preferred.

OTHER CREDENTIALS / CERTIFICATIONS:

Certification relevant to quality, safety, performance improvement, or project management preferred.

PHYSICAL REQUIREMENTS:

(Physical Requirements are based on federal criteria and assigned by Human Resources upon review of the Principal Job Functions.)

(DOT) - Characterized as sedentary work requiring exertion up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.