Quality & Safety Oversight Specialist V, Clinical Quality Oversight

Job Summary

In addition to the responsibilities listed above, this position is also responsible for partnering with the Board of Directors in providing oversight of systems designed to monitor and ensure the quality care and services are provided at a comparable level to all members and patients across the continuum of care; serving as a point of escalation for complex issues in quality improvement systems;

proactively identifying and communicating issues related to the organization meeting the standards established by regulatory agencies and accreditation organizations and meeting public expectations; ensuring the integrity of systems related to the selection, credentialing and competence of physicians and other health care practitioners; monitoring systems for granting or terminating clinical privileges, professional staff or medical staff or clinical staff membership, proctoring and continuing education;

reviewing and approving medical staff or provider staff Bylaws, Rules and Regulations and amendments; and managing the oversight of systems of all contracted entities including but not limited to the Permanente Medical Groups. This role is also responsible for leading the peer review process, committees, and forums through evaluating and integrating direct information on hospital or health system performance; developing comprehensive feedback;

and refining and communicating a strategic development plan to address needs and solve problems.

• Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit.
  
  Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams.
• Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals.
  
  Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
• Serves as the subject matter expert for clinical quality improvement processes and regulations practitioners, Quality Specialists, department managers, and peers, projects/committees, and internal stakeholders by: providing consultation on the interpretation and interaction of current policies, and how they interact with the current climate, and potential changes to regulations and legislation; serving as a technical advisor on committees, projects to drive discussions on drawing guidelines on the enforcement, development of policies or procedures of regulations and auditing processes;
  
  maintaining collaborative, results oriented partnerships with practitioners and/or staff across clinical and administrative roles to ensure compliance with regulations and improve patient safety, reporting accuracy, and health outcomes and provides insight to the regulation climate; developing educational programs to raise awareness for current and changes in regulation requirement, internal concerns, and system/database usage; and anticipating issues, weighing practical and technical considerations in addressing issues, and coordinating with the appropriate stakeholders to develop resolutions.
• Develops the quality of care complaints and the review process by: coordinating grievance meetings, cases, reviews, referrals, or other mechanisms by…