Mar 25, 2020

Director, Quality Improvement

  • Professional Diversity Network
  • Lauderdale Lakes, FL, USA
Full-Time Other

Job Description

Catholic Health Services


Summary & Objective

The Director of Quality Improvement is responsible for overseeing all the quality assurance, medical records and education activities of the organization to include monitoring, implementation and evaluation of process and programs to meet regulatory, CHAP accreditation and standards of practice.

Knowledge & Experience Requirements

  • Clear and Active Registered Nurse license to practice in the state of Florida.
  • Bachelors Degree in Nursing or related field required. Masters Degree Preferred.
  • 2-5 years of experience in quality improvement and measurement, systems analysis, utilization review, or some form of regulation implementation required.
  • Experience in a Home Health agency or related healthcare field preferred.
  • Knowledge of POC, OASIS, QA required.
  • 5-10 years of management experience required.
  • Must have knowledge of computer office/clinical software.
  • Must be able to read, write and understand the English language.

Essential Functions

  • Provides leadership and support around quality improvement and assurance activities.
  • Plans, develops, coordinates and implements the QAPI program, including but not limited to quality assurance, performance improvement, medical records, and regulatory compliance.
  • Manage the measurements and reporting of public databases.
  • Reviews and evaluates data to determine the opportunity for improvement of care.
  • Identify trends and provide recommendations to the education, quality improvement, and management teams.
  • Oversees the development of quality metrics to support performance improvement initiatives and quality/compliance oversight.
  • Leads the advancement and integration of quality assessment and quality performance improvement strategies for Home Health agency, and Medicaid/Medicare products in collaboration with Senior Leadership and service delivery management.
  • Ensures that data-driven performance management and quality improvement programs are designed and implemented in a manner that aligns with an organizations overall strategy.
  • Works with executives to develop performance improvement programs that support long-term goals.
  • Measures and evaluates data to determine the ultimate impact of the programs on both the medical operation and the health of patients.
  • Develops in collaboration with other staff the preparation and development of the Quality Improvement Plan for the organization.
  • Responsible for analysis of patient satisfaction and related activities as part of the quality program; participate in the planning and implementation of activities for managing patient satisfaction.
  • Acts as a resource for all staff in the organization on regulatory issues related to quality management and performance improvement techniques.
  • Oversees all activities related to clerical support for the Quality Assurance/Performance Improvement/Education Departments.
  • Directs the education department while assessing and planning the ongoing education needs with emphasis on compliance and competence.
  • Develops and manages new employee orientation in conjunction with the Human Resources Department.
  • Participates in Quality Improvement studies as they relate to continuing education and the educational needs of the organization.
  • Develops and maintains educational materials and orientation manuals, especially related to clinical nursing skills.
  • Performs duties of Infection Control Nurse by collecting data, teaching and providing OSHA required topics and preventive measures.

*Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.

Other Duties

  • Assesses and plans the ongoing educational needs, with an emphasis on the clinical skills.
  • Mentors completion of nursing staff field competencies by observing and giving evaluation feedback to supervisor during introductory period.
  • Collaborates and coordinates sharing of information with appropriate personnel organizationally, and with other agencies regarding findings, surveys, regulations.
  • Ability to perform statistical/quantitative analysis.
  • Leads special initiatives and ongoing efforts in areas of quality assessment and practice improvement.
  • Facilitates and supports operational changes and activities which further quality improvement and clinical staff development goals.
  • Promotes and oversees safety and security procedures and uses equipment and materials properly.
  • Establish and maintain effective partnerships across organizational boundaries.
  • Typically solves problems by considering courses of action within the framework of managements goals and standards.
  • Responsible for the integrity and accuracy of organizational documents and reports.
  • Participate in educational activities related to Home Health.
  • Coordinates several projects at the same time while prioritizing competing demands on time frames.
  • Ability to synthesize complex or diverse information.
  • Must handle sensitive information and maintains confidentiality.
  • Maintains knowledge of industry trends and clinical standards and insures compliance.
  • Promotes positive employee engagement, teamwork, mutual respect and safety work practices.
  • Maintain your required licenses, certifications and mandatory skill updates.
  • Comply with all policies, local, state and federal laws and regulations.
  • Provide other duties of healthcare team member.
  • Perform other duties as assigned.

Supervisory Responsibility

May serve as an interim department leader depending on need

Physical Requirements

  • Must be able to lift and/or move up to 50 pounds and push/pull up to 250+ pounds, walk, climb stair or ladders, stand on feet for extended periods of time, etc.


The job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.



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