Director of Health Services and Quality Improvement

*Seeking experienced RN for large healthcare company in Broward. This position is responsible for the supervision of daily operations within the Health Services and Quality Improvement department including supervision and management of Case Management Nurses. Position is responsible for the implementation and maintenance of Quality Program for the company. If you are interested in this great opportunity, please do not hesitate to contact me for immediate consideration. John Hall 954-358-0380

Primary Responsibilities and Duties:

• Medical Records review oversight to ensure standards and specifications of contractual requirements are met.
• Directs the administration and execution of medical programs related to Primary Care Physicians.
• Preparation of reports
• Coordination of all department activities in accordance with company policies and procedures.
• Responsible for compilation, identification, and reporting of trends as noted to Senior Staff.
• Implements the Quality Improvement Program, Work Plan, and all relevant policies and procedures in accordance with the mission and strategic goal of the company and industry standards.
• Ensure an annual evaluation of the Quality Program
• Education of staff and practitioners on QI related polices and procedures
• Implements systems and policies and procedures for identification, collection, and analysis of performance measurement data
• Collects and summarizes performance data, identifies opportunities for improvement, documents, and reports findings to Senior Staff.
• Assists in the presentation of QI statistical data to committees for review
• Collaborates with Chief Medical Officer on all QI activities
• Monitors and assists in ensuring compliance with all regulatory standards in QI related activities.
• Ensures timely submission of QI reports to Director of Compliance
• Employee’s Yearly Evaluations
• Responsible for attendance at meetings.
• Other duties as assigned.
REQUIREMENTS
Position Knowledge and Skill Requirements:

• RN preferred.
• Bachelors/Masters Degree preferred.
• Related educational emphasis in healthcare preferred.
• Four (4) years of healthcare experience, at least two (2) of which are management in the healthcare field.
• Knowledge of principles and skills in communication and organization healthcare delivery systems, personnel and management techniques.
• Knowledge of Federal and State requirements, CMS, AHCA, DCF and Managed Care Systems.
• Medical terminology.
• ICD-9 and CPT-4 coding.
• InterQual or Millerman & Robertson Criteria.