Job Description

Job Description

Job Description

Salary: $100,000 starting

Responsibilities: This is a senior staff position that reports to the CEO and serves as part of the executive team. This position is responsible for directly influencing organizational performance through management of regulatory compliance, process improvement, and risk management efforts. The Chief Quality & Risk Officer provides executive leadership and is responsible for Board of Director’s monitoring capabilities in carrying out oversight and governance responsibilities. Assists executive leadership in ensuring compliance with all laws and regulations, accrediting bodies and best practices in delivery of health care services. Ensures that the Quality and Risk Management goals and objectives are accomplished. The Chief Quality & Risk Officer ensures compliance with state and federal regulations and directly assists in the handling and defense of legal claims.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Collaborates with all levels of management to ensure organizational compliance with all laws, regulations, and related practices associated with the delivery of services.
• Manage all outstanding Federal Torte Claim Act (FTCA) claims, including reporting to and collaborating with insurers and Health and Human Services Office of the General Counsel.
• Provide oversight of COMC’s EHR, including template development, mapping, clinical modules, patient satisfaction, and other program functionality.
• This position develops and implements the Quality Improvement and Risk Management program for COMC. The comprehensive program includes medical, dental and behavioral health.
• Effective management of Quality staff to accomplish organizational goals.

Quality Assurance : As part of the daily responsibilities the Chief Quality & Risk Officer will:

• Assists management in the development of performance improvement and quality initiatives including the establishment of specific performance measures.
• Provides oversight regarding quality-of-care reviews and reporting to the Board of Directors Quality Committee.
• Coordinate quality assurance/improvement activities within the organization.
• Monitors clinical and management indicators based on internal and external benchmarks.
• Measure quality of care against established targets, organizational goals and industry benchmarks.
• Responsible for the internal credentialing process for all healthcare providers on staff; collect necessary documentation; process applications and reappointment paperwork; ensure primary source verifications.
• Communicate quality improvement activities and results through regular reports to the Board, executive leadership and staff.
• Provide staff education on quality improvement models, corporate compliance and privacy policies.
• Provide data reporting on UDS clinical indicators, meaningful use measurers, state/federal collaborative activities, and patient satisfaction program
• Coordinate data to meet and maintain PCMH, HEDIS, and other program requirements to ensure organizational compliance.
• Ensure compliance with state and federal regulations.

Risk Management : As part of the daily responsibilities the Chief Quality & Risk Officer will:

• Manage the organization’s risk management and risk reduction initiatives.
• Monitor adherence to risk management initiatives to ensure COMC meets all requirements for successful accreditation by HRSA, FTCA, state and local departments of health, and related professional accrediting organizations.
• Develop and implement preventive risk management programs.
• Educate and train staff in appropriate procedures, documentation, reporting, and follow-up in key areas of risk management interest.
• Act as the facility’s expert resource in risk reduction and remain abreast of trends in the industry.
• Evaluate all incidents for severity, frequency, and probability of financial loss, and reports as necessary to appropriate administration, committees, and personnel.
• Maintains the incident reporting system by establishing a comprehensive incident reporting plan that establishes policies, educational programs, and reporting methods for the appropriate areas.
• Provide information on incidents as appropriate to medical staff and nursing peer review processes. Uses benchmarking to compare appropriate data.
• Serves as a resource to facility staff on issues related to risk management and patient safety. Demonstrates role model behavior regarding proper customer satisfaction, conduct, confidentiality, complaint resolution, and problem solving.
• Facilitate the identification, monitoring and reporting of annual risk management goals.

Claims Management : As part of the daily responsibilities the Chief Quality & Risk Officer will:

• Informs appropriate individuals of significant cases.
• Maintain chain of custody on all medical records with outstanding claims, and maintains all evidence, documents, and communications on legal cases in a confidential manner. Sequesters medical records as necessary.
• Act as the primary spokesperson for the facility to persons who have a complaint that may be considered a potentially compensable claim in conjunction with the Chief Executive Officer.
• Coordinate with the Chief Executive Officer to liaise with outside litigation counsel in the management and investigation of filed lawsuits and related litigation processes. Understands the legal components of the risk management industry.

Qualifications Requirements : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Education and/or experience: Bachelor’s degree required. Advanced degree in business, healthcare administration, or related field preferred. Experience in healthcare preferred. 3-5 years of healthcare leadership experience required. Demonstrated expertise related to laws, trends and issues in the area of primary healthcare, public health, behavioral health, and HIPAA. Demonstrated success in management of accreditation standards and requirements and the development of quality improvement measures. Undergraduate or graduate coursework in statistics, data analysis, research methods; 2-5 years’ experience in quality improvement, data analysis, regulatory and accreditation activity preferred.

Language Skills : Ability to respond to inquiries or complaints from customers and regulatory agencies.

Social and cultural sensitivity appropriate to ethnically and economically diverse patient and employee base.

Mathematical Skills : Ability to work with data and statistical analysis.

Reasoning Ability : Ability to define problems, collect data, establish facts, and draw valid conclusions.

Other Skills and Abilities :

• Performs all duties and assignments dependable, whether supervision is present or not.
• Expresses ideas, information, and instruction in a positive and effective manner.

• Works cooperatively with coworkers and supervisor. Acts as an effective team member with other employees through cooperation.
• Makes reasonable and appropriate decisions.
• Readily and effectively adjusts to changing ideas and activities.
• Acts as a good role model for other employees.
• Shows imagination and innovation in solving problems.
• Reliably reports for work as scheduled, willing to work OT when needed.
• Follows all safety rules and works in a safe manner.

• Produces an acceptable amount of work, of sufficient quality in an appropriate amount of time.
• Ability to gain expertise related to trends and issues, laws and regulations associated with the delivery of dental and oral health services.
• Ability to work with challenging patients and staff with Empathy and Compassion.
• Strong training and excellent customer service skills.

Physical Demands : The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This includes moderate physical effort consisting of occasionally lifting or moving over 35 pounds of weight.

Travel Requirement : To fulfill the responsibility of the position travel to all COMC locations will be required. Employee should have valid Missouri driver’s license. Overnight travel may also be required in specific incidences of training, conferences, etc.

Work Environment : The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Knowledge of, and compliance with, HIPAA and 340B regulations is required. Confidentiality of patient information is mandatory.

About COMC:

Central Ozarks Medical Center has been providing quality health care in Central Missouri since 1979. Central Ozarks Medical Center’s staff members are committed to leading the way to healthier communities. COMC offers a wide range of services based on the needs of the communities we serve. We pride ourselves on offering high quality healthcare regardless of insurance status.

Our Mission

COMC is committed to leading the way to healthier communities by reducing barriers to care, ensuring access for all, and creating a positive working environment of engaged team members with a shared goal.

Our Values

At COMC, we use the following strategically anchored values to guide all our actions:

Selfless Service: We lead by example Passionate: We promote community.

Approachable: We communicate openly Resilient: We enable and Inspire

Responsive: We take action Resourceful: We collaborate

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