Director Quality Management | Hospital / Flagship Facility | Coastal Texas

Competitive Compensation | Annual Bonus | Superb Benefits Program | Relocation Assistance

Coastal Texas

• Reports to Regional Quality Management Director with dotted lines to the facility CNO, CMO, and CEO
• ADC: 290 | Level II Trauma Center
• FTE count (department undergoing staffing assessment)
• Directs the daily activities of the Quality Management Department
• Develops quality outcome reporting and analytic insights using knowledge and expertise about public reporting, metrics, analytics, and application tools
• Oversees continual compliance readiness with leadership in providing Joint Commission and other accrediting or licensing body reviews and education
• Researches and recommends quality management objectives
• Develops reports to effectively convey regulatory updates from appropriate data sources and systems, including national benchmarks and public ranking data
• Supports production of reports in collaboration with subject matter experts
• Educates the hospital and medical staff on matters related to quality
• Oversees and coordinates the process of regulatory accreditation, including preparing and monitoring the hospital staff for a constant state of readiness, compliance with standards, and promoting a culture of safety
• Collaborates with the hospital leaders to achieve quality goals and eliminate preventable harm
• Provides expertise in quality management for inpatient and hospital outpatient department delivery settings
• Brings high-reliability processes and information governance strategies to the performance of job responsibilities to the organization

• Bachelors degree required; Master’s degree preferred
• Current RN License preferred but not required
• CPHQ - Certified Professional in Healthcare Quality
• CPHRM, or CPPS a plus
• 5-7+ years of experience managing quality outcomes, sizeable disparate data sets, systems improvement, and accreditation standards
• Knowledge of Federal, State, and Local regulations related to health care and accrediting/certifying agencies such as The Joint Commission and CMS
• Ability to establish and maintain effective working relationships with all levels of hospital staff
• Strong written and verbal communication and proficient computer skills required

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