The Quality Improvement Manager directs, coordinates, develops, implements, and evaluates the quality improvement program and associated initiatives for dialysis and transplant facilities in the state of Illinois for The Renal Network. The objective of this position is to provide technical expertise in the development and implementation of quality improvement, quality assurance, medical review, and patient advocacy programs. Supports other functional areas of the organization as directed and performs other duties as assigned. The position is based in the Indianapolis, IN office and reports to the Executive Director.
Major Duties and Responsibilities:
Responsible for coordinating Quality Improvement Activities as directed by the CMS Contract.
Plans, implements and evaluates quality improvement activities which includes:
Writes quality improvement project plans,
Reviews and analyzes clinical performance measures,
Educates facilities in the principles of continuous quality improvement,
Develops, executes and evaluates the effectiveness of intervention activities to support customer focus
Consults with data teams regarding collection/analysis of pertinent project data,
Maintains project specific records
Reports to the Medical Review Board (MRB).
Prepares final reports to the MRB and Centers for Medicare and Medicaid Services (CMS).
Ensures quality improvement activities are conducted in compliance rules and regulations of the Centers for Medicare and Medicaid Services (CMS) Network statement of work.
Supports Internal Quality Improvement initiatives
Maintains proficiency with the Network Scope of Work (SOW) as specified in the CMS Contract.
Analyzes data and maintains records as directed by the CMS contract.
Direct supervisor to Quality Improvement Specialist
Community Outreach and Patient/Facility Staff Education
Provides technical assistance to Network facilities and education to clinical staff on continuous quality improvement techniques, national and regional quality improvement initiatives, patient safety, and in-house quality assurance programs as requested, and in response to findings of quality improvement projects, other special studies, and/or recommendations of the Medical Review Board.
Assists in the organization and implementation of educational programs related to the Network Scope of Work and other topics as required by the CMS and/or recommended by the Network's Medical Review Board and Board of Directors.
Acts as liaison between dialysis facilities within Network 10 area and the Centers for Medicare and Medicaid Services (CMS) regarding patient data collection and quality improvement initiatives.
Serves as an educational resource to physicians, dialysis facilities and medical professionals for regulatory information, quality improvement materials, and patient care references related to nephrology.
Assists in the planning and implementation of educational meetings as necessary.
Serves as primary staff to the Medical Review Board and other designated subcommittees as needed.
Works with the Executive Director and MRB chair in scheduling Medical Review Board and subcommittee meetings. Prepares agendas, minutes, and other documentation, as requested, related to Medical Review Board activities.
Creates PowerPoint presentations to be used in presentations to physicians; prepares and presents overview and project progress to The Renal Network’s MRB members via webinar and in-person meetings.
Monitors receipt and timeliness of information needed for contract deliverables
Oversees the Network’s Internal Quality Control (IQC) Program and communicates with staff to provide recommendations.
Presents and/or prepares reports to the MRB on topics related to quality improvement.
Works with the Executive Director to create and enhance reports.
Completes quality improvement portions of monthly COR report and discusses with COR on monthly call
Network Staff Support
Provides status reports of quality improvement activities for the Monthly COR Report and Annual Report.
Attends CMS and Network meetings as necessary; attends professional nephrology organizations such as the National Kidney Foundation, NAHQ and INAHO as required.
Serves as a resource to the Patient Services Director; acts as back up as necessary to the Patient Services Coordinator by answering Medicare beneficiary and facility personnel questions pertaining to dialysis, transplants, Medicare, patient care issues and grievances.
Manages QI Team and collaborates as appropriate with other ESRD Networks and staff
Coordinates internally with Data and Patient Services teams, and Community Outreach and Operations staff to ensure timely delivery of quality improvement activities, patient resources, and pertinent information to stakeholders
Assists facilities during emergency situations as necessary.
Network Disaster Team member co-lead on establishing disaster policies, plans and rehearsals with emphasis on data and infrastructure recovery.
Knowledge, Skills and Attributes:
Ability and desire to collaborate, share and support team members is an essential component of the job.
An individual must be able to successfully work with team members on job functions that require coordination of multiple team members to complete tasks, while adhering to organizational and departmental structures.
To perform this job successfully, an individual must be proficient in the use of Microsoft Office products; Spreadsheet software; E-mail Internet software; Database software; and Contact Management systems.
Travel may be required.
Registered Nurse with BSN or MSN and/or at least five years of quality improvement experience, related experience and/or training; or equivalent combination of education and experience; healthcare setting preferred.
Minimum of three (3) years of direct supervisory/management experience is preferred.