System Director of Quality Management and Accreditation

Pay Range:$75.26 - $105.59 Responsible for the leadership, strategic direction, and management of the day-to-day activities of all Quality Management & Accreditation/Quality and Risk Management program, including accreditation, infection prevention and control, employee health screening, patient safety, risk management, compliance, credentialing, coordination of regulatory and accreditation compliance survey, and all other quality related activities.

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more.

Shift Details

• M-F 40

Key Essential Functions and Accountabilities of the Job

• Develops and maintains the structure of the Quality Management & Accreditation division and fosters cross-disciplinary, cross-department, and cross-jurisdictional relationships.

• Develops and manages the SEARHC Quality Management & Accreditation/Quality Management program; leads and integrates quality improvement beyond the clinical setting to all divisions. 

• Formulates, analyzes and implements Quality Management & Accreditation policies, programs and procedures in alignment with SEARHC objectives.

• Manages SEARHC’s accreditation requirements to ensure compliance with accrediting body standards; provides guidance regarding credentialing issues; serves as subject matter expert for interpretation and application of accreditation standards.

• Approves and ensures compliance by applying consistent quality improvement processes; understands and utilizes rapid PDSA (Plan-Do-Study-Act) cycles as part of the performance/quality improvement initiative; implements SEARHC Quality Management (SQM) concepts and perfect performance/quality improvement measures; promotes the SEARHC Seven Standards of Excellence.

• Works with Electronic Health Record (EHR) staff to incorporate capacity for quality measure; trains staff, providers, etc. to input quality measurement data; develops quality measurement reports.

• Provides technical and/or administrative support to staff, patients and others in resolving complaints and/or administrative problems; investigates complaints and concerns by collecting pertinent information; provides summary and recommendation action to the COO or directly respond to patients, staff, or others as appropriate; reports findings to Executive Leadership Team and/or SEARHC Board of Directors. 

Other Functions

• Other duties as assigned.

Supervisory Responsibilities

• This position does require supervisory responsibilities.

Additional Details:

Education, Certifications, and Licenses Required

• RN License or comparable clinical degree with experience and other specialized education/training in Quality Management / Performance Improvement.

• Master’s degree in health related or business field preferred

• Certified Professional in Healthcare Quality (CPHQ) required within 18 months of hire

Experience Required

• Five years’ health care administration or performance improvement management experience

• Three years’ experience supervising health care professionals

Knowledge of

• Quality and performance improvement strategies and processes

• Accrediting agency requirements, infection prevention, safety practices, risk management and total quality management principles

• Alaska Native/American Indian health problems and the health service delivery program for Alaska Native/American Indians

Skills in

• Program planning, implementation and evaluation

• Critical thinking

Ability to

• Lead, motivate and maintain a high performing team through effective performance management, communication and mentoring/coaching

• Communicate with all levels of the organization professionally and comfortably present to internal and external audiences, physicians, media, and administration

• Affect change through influence, working closely with all departments

• Operate with a sense of urgency with rapid response capabilities, on constricted timelines and able to manage multiple projects at one time, with varying priority

• Understand changing healthcare market dynamics, translating them into actionable strategy and implementing the strategy to achieve pre-set objectives

• Apply broad knowledge and experiences when making sound decisions under conditions of uncertainty and time pressure.

• Analyze and understand the financial and ethical implications of health program decisions

Travel Required

• Travel expected.

• Travel is by jet, small aircraft, and ferry.

Position Information:

Work Shift:Exempt

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!