Job Description

Northern Light Medical Management is seeking a dynamic and experienced Director of Risk Management and Quality Assurance with experience specifically in hospital-based radiology departments. The ideal candidate will be a strategic thinker with a proven track record of leadership and quality assurance in a hospital-based operations environment. 

We are a successful, growing, hospital-based Medical Management company looking for the perfect candidate who is dedicated to teamwork and operational excellence. 

Required Qualifications:

• Bachelors Degree in Business Administration, Nursing, Health Care Management or other relevant field. MBA and RN preferred 
• Minimum five years’ experience in risk management 
• Certified Professional in Healthcare Risk Management (CPHRM) 
• Experience in hospital-based radiology practice setting is preferred. 
• Excellent communication and interpersonal skills to include the ability to negotiate and resolve conflicts, build teams, foster trust, credibility and understanding 
• Ability to recognize personal strengths and weaknesses and develop goals for professional growth and achievement 
• Ability to operate in high-pressure situations 
• Excellent and effective organizational, planning, and project management abilities 
• Broad knowledge of modern health care and administration practices and principles 
• Effective ability to analyze options, recommend solutions to and resolve complex problems and issues 
• Effective managerial and administrative leadership style 
• Ability to implement change in a positive, sensitive and forward-thinking manner 
• Proven experience developing goals and objectives, and establishing priorities 
• Ability to persuade others and develop consensus 
• Ability to ensure a high level of customer satisfaction including employees, contracted physicians, health care organizations and external stakeholders 

Peer Review and Quality In itiatives Responsibilities

1. Random Review. This review utilizes the RADPEER application for the purpose of randomly reviewing not less than two (2%) of cases performed by the organization’s physicians including locums. The Peer Review Body can modify the review criteria from time to time for the purpose of optimizing review methods and achieving statistically significant results. RADPEER reports are generated and reviewed by the Peer Review Body on a monthly basis.

2. Focused Review. This process involves the review of suspected client-reported errors. Chief Medical Officer, or Designee, shall cooperate with client in reviewing the request and related medical records for each reported incident. Based on this review an error a code will be assigned.

3. Baseline Review. This process involves the initial assessment of a physician’s readings of various types of reports and is established to develop a “base line” for subsequent quality assessment of physician’s work.

Departmental Leader Role and Responsibilities

• Supervises Northern Light’s Risk and Quality Management Department (the “Department”); incorporates the Northern Light’s vision, missions and values in goals and programs within the Department
• Assures proper storage, handling, and maintenance of risk and quality related information in the organization’s computer systems; assures that records are complete, accurate, available, and in compliance with all legal, regulatory, and policy requirements
• Acts as a member of Quality Assurance Committees (“QAC”) for Northern Light practice-level companies; participates in relevant meetings; maintains the custody of QAC records; promotes the timely consideration of QAC recommendations; and acts as a liaison between the QAC members and the non-clinical leadership of the organization 
• Develops and implements clinical outcome measures for quality improvement, cost and complication reduction, reduction of turn-around times, and the implementation of evidence-based medicine 
• Supervises Northern Light’s peer review programs (“PRP”); assures the proper and timely collection, maintenance, and reporting of risk and quality KPIs including without limitation the outcomes random and non-random PRPs 
• Effectively communicates with clinical personnel to promote quality of care and/or communicate or follow up on QAC recommendations 
• Participates in leadership meetings and, from time to time, travels to client’s facilities as directed by Chief Executive Officer 
• Creates and enforces corporate culture centered on the primacy of quality in patient care; treats every quality related incident as a learning opportunity for both the involved personnel and the organization as a whole
• Assesses risks and impact of organizational change for staff and develops strategies for successful implementation 
• Analyzes risk and quality related information and develops improvement initiatives with measurable and reportable outcomes 
• Formulates objectives, goals and strategies collaboratively with other stakeholders 
• Establishes, in collaboration with Chief Executive Officer, annual financial goals and budgets; actively uses benchmarking to assess financial performance of the Department generates timely repots as may be requested by the financial and accounting team 
• Runs monthly Quality Assurance / Peer Review Meetings with Northern Light Medical Directors and Chief Medical Officers 
• Reports Quality Data to facilities on monthly /ad-hoc basis 
• Interacts with Medical Malpractice Carrier on MedMal matters 
• Interacts with facility Risk Management departments on Risk related matters 
• Ensures all physicians comply with CMEs and required by State Law and as recommended by Peer Review Committee 
• Remains current of new trends and best practices and incorporates them into risk management practices and quality assurance programs; maintains membership in professional organizations to develop knowledge and resources through networking, continuing education, and participation in national, regional, and/or local activities 
• Actively listens to staff ideas and concerns, assesses others communication styles and adapts to them 
• Contributes to a learning environment by providing educational and research experiences to relevant personnel; conducts regular webinars or similar events aimed at improving the personnel’s understanding and compliance with risk and quality related requirements 

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