Organization:

MPHS-Mills-Peninsula Medical Center Position Overview:

Responsible and accountable for facilitating, measuring, evaluating and reporting on the clinical and operational performance of system-wide patient safety and clinical quality initiatives. These initiatives may include, but are not limited to, The Joint Commission (TJC), Center for Medicare Services (CMS), Quality Net (QNet), Leapfrog, National Patient Safety Foundation (NPSF), National Healthcare Safety Network (NHSN) for Acute facilities and Institute for Medical Quality (IMQ) and Integrated Healthcare Association (IHA) for Ambulatory facilities as well as initiatives driven internally and obtained through various data sources as applicable. Responsible for the effective management of staff including hiring, performance evaluations, employee growth and development, satisfaction and as needed counseling and disciplinary actions. Coordinates and participates in the planning, data collection, data analysis, implementation and follow up for multifaceted quality performance assessment and improvement projects for affiliate. Develops protocols for the collection of data and designing data collection instruments. Collaborates with the abstraction and analytic team to compile and analyze results; composes status reports on analyses. Designs and delivers presentations of material developed. Manages project budget and timelines. May manage chart abstraction staff. Functions as project leader and manager. Works on performance-measurement, target-definition, evaluation and reporting expertise necessary to drive significant breakthroughs related to patient safety, risk reduction, and clinical quality and care management performance. Responsible for independent action in performance measurement metrics and a variety of special projects. Participates in evaluations of current information processing systems and coordinates planned changes, upgrades, and conversions as appropriate. Collaborates with personnel responsible for EMR, internal reporting platforms, and Sutter Information Services as well as other available databases to measure performance. Continually facilitates management and clinical leaderships' ability to monitor and review relevant and focused results to include customer input, reimbursement, patient safety, clinical quality, and regulatory compliance.

Job Description:

EDUCATION

Equivalent experience will be accepted in lieu of the required degree or diploma. Bachelor's

CERTIFICATION & LICENSURE

RN-Registered Nurse of California OR MD-Medical Doctor (may be international) OR PharmD-Pharmacist OR PA-Physician Assistant OR NP-Nurse Practitioner

TYPICAL EXPERIENCE

8 years recent relevant experience

SKILLS AND KNOWLEDGE

Knowledge of database architecture and management and data extraction methods required. In-depth experience with Midas, including Quality, Risk and Case Management modules, and/or Epic EHR, or the equivalent. Experience with Statit PPR, Statit PiMD, Tableau, Crystal Report Writer and/or Allscripts or the equivalent. Advanced SQL knowledge and experience Advanced skill with presentations, word processing and spreadsheet applications with an advanced knowledge of Microsoft Office Suite required. Must be advanced in MS Excel. Advanced analytical skills with the ability to collect, analyze, and disseminate significant amounts of information with attention to detail and accuracy. Experience with statistical methodology is required. Knowledge of health care operations, and health care (International Classification of Diseases (ICD 10), Current Procedure Terminology (CPT) and/or Diagnosis Related Groups (DRG)) coding with a focus on quality management and care coordination services in acute and non-acute outpatient settings. Includes structure, department-specific policies and procedures and workflows. Requires teamwork, organizational and communication skills. ability to be involved in, and prioritize multiple projects at the same time in a rapidly changing environment. Must have the ability to interact with all levels of employees and medical staff as well as interface directly with external agencies and organizations. Must have ability to organize, interpret and present data effectively; creatively and effectively problem-solve, good decision-making skills. Leadership, communication and teaching / training skills.

Job Shift:

Days Schedule:

Full Time Days of the

Week:

Monday -

Friday Weekend Requirements:

As Needed Benefits:

Yes Unions:

Yes Position Status:

Exempt Weekly Hours:

Employee Status:

Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $168,958.40 to $270,337.60 / annual salary The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package. Working at Sutter Health Sutter Health values and supports the unique talents and strengths that each employee brings to our organization. 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