PROPOSED POSITION DESCRIPTION
JOB TITLE:Director, Quality / REVISION DATE:

DEPARTMENT:Quality Management

/ LOCATION: Paynesville

REPORTS TO:Chief Executive Officer

/ SALARYRANGE:
FUNCTION/PURPOSE:
•Oversees all aspects of the organization’s quality improvement efforts, such as developing and administrating the process, training and coaching staff in process improvement and facilitating change throughout the organization.
•Responsible for establishing quality related strategic plans, policies and procedures at all levels of the organization.
•Responsible for implementation and integration of quality process improvement efforts that will meet or exceed internal and external customers’ needs and expectations from beginning to cultural integration
PHYSICAL REQUIREMENTS:
  • Requires prolonged sitting and telephone usage. Requires the use of office equipment such as personal computer, telephones or copiers. Requires normal vision range. Infrequent lifting up to 10 pounds. Need cognitive ability to multi-task, meet deadlines, and manipulate numbers.

No. /

ESSENTIAL JOB REQUIREMENTS

/ % of Job Performed
1 / Responsible to develop, implement and evolve a company-wide framework to support ongoing continuous performance improvement. Develop and facilitate quality and process improvement education curriculum. / %
2 / Manages Quality Steering Committee to support ongoing work redesign, system changes and identification and analysis of opportunities for improvement. / %
3 / Coordinates Risk Management activities for review through adverse health events, healthcare guidelines and reviews incident reports for trends and analysis for correlation with quality assurance/improvement activities. / %
4 / Facilitates, communicates and administers quality measurement activities. Applies statistical techniques to track and trend issues / results.
5 / Act as internal consultant to administration and management staff for development and direction for performance improvement efforts overall. Promotes quality initiatives with external customers and suppliers. / %
6 / Administrative responsibilities include budget preparation and management. / %
7 / Facilitates, communicates and supports the activities needed to obtain measurable results of continuous improvement, i.e., facilitation of process improvement teams, customer satisfaction surveys. Facilitates corrective/preventive action. Facilitate departments and groups in implementation of change. / %
8 / Enhance self-knowledge of quality initiatives through reading and participation in seminars, workshops, etc. / %
9 / Performs other duties and assumes other responsibilities as apparent or assigned, including mutually agreed upon objectives. / %
SUPERVISION RECEIVED:
•General direction from CEO. Position has great latitude to achieve goals and objectives. Position must be self-motivated; a great deal of discretion is required to achieve goals and objectives.
•Direction from Medical Staff officers and Medical Staff in areas of medical staff quality systems and credentialing.
•External direction from liability carrier, legal counsel, accrediting bodies and governmental bodies (PRO, State Department of Health).
•Executive Council direction for projects related to work redesign and/or process changes or implementation of new systems.
PERFORMANCE REQUIREMENTS:
Knowledge, Skills & Abilities:
•Use of analytic skills required.
•Knowledge of data management systems highly desired.
•Must possess knowledge regarding CQI theory, peer review status, applicable laws regarding medical-legal principles.
•Must possess high level of communication and interpersonal skills.
•Facilitation skills
•Strong written and verbal communication skills
•Administration skills
•Leadership capabilities.
•Protocols and Policies - Demonstrates understanding of company-wide and department-specific policies and protocols.
EDUCATION:
•A Licensed Registered Nurse with a minimum of a Bachelor’s degree as a RN or related healthcare field. Masters preferred.
•College degree (preferably in business Administration, Communication, Education) or equivalent work experience
•Minimum of ten years of business experience, and understanding of quality, process improvement, and measurement concepts
EXPERIENCE:
•Three to five years experience in a healthcare quality system desired.
•Management and quality system experience required.
CERTIFICATE/LICENSE:
•Currently licensed in the State of MN as a Registered Nurse.

Position Description: Director, QualityPage 1 of 2

Paynesville Area Health Care System