Tests and inspects polyethylene and cellophane sheets or bags for surface defects, dimensional accuracy, strength, and clearness of print to verify conformance to specifications, and to assist production personnel in solving quality control problems. Inspects sample sheet to detect surface... [+] More

Tests and inspects polyethylene and cellophane sheets or bags for surface defects, dimensional accuracy, strength, and clearness of print to verify conformance to specifications, and to assist production personnel in solving quality control problems. Inspects sample sheet to detect surface defects, such as bubbles, pattern defects, and haze variations. Measures thickness of sample, using micrometer, and weighs sample to determine compliance to specifications. Tests sample strips in pull-tester machine, impact tester, and stress-flex test machine to determine strength, tenacity, and flexibility. Places adhesive paper on printed section, pulls paper from printed section, and examines adhesive for ink to verify stability of print. Prepares inspection and testing reports and confers with production personnel to determine cause of deviations from qualitative standards. [-] Less

Provides executive leadership over the hospital’s quality improvement process and programs.

Leads the organization's medical quality improvement programs and processes. Provides training and guidance to staff to ensure understanding and that quality, accreditation, and performance improvement are actively pursued. Defines methodologies... [+] More

Provides executive leadership over the hospital’s quality improvement process and programs.

Leads the organization's medical quality improvement programs and processes. Provides training and guidance to staff to ensure understanding and that quality, accreditation, and performance improvement are actively pursued. Defines methodologies and directs the collection and analysis of data. Implements processes and methodologies for the identification and sharing of best practices. Promotes support for best practices and evidence-based medicine. Coordinates and oversees quality improvement efforts in operating units. Develops strategic initiatives and transforms initiatives into action plans. Develops and fosters effective collaboration between departments and other affiliated services to ensure an integrated approach to quality management. Facilitates and coordinates the redesign of processes and systems for improvement with a central focus on patient centered care and services, customer satisfaction, safety, resource efficiency, quality, and employee satisfaction. Develops new strategies to improve overall performance. Hires, develops and motivates a qualified quality management/improvement staff. This position requires a Medical Doctor. [-] Less

Develops, implements, and coordinates, through support staff and lower echelon managers, product assurance program to prevent or eliminate defects in new or existing products. NOTE

For hospitals, please see Quality Assurance Head Hospitals.

Analyzes, evaluates, and presents information concerning factors, such as... [+] More

Develops, implements, and coordinates, through support staff and lower echelon managers, product assurance program to prevent or eliminate defects in new or existing products. NOTE

For hospitals, please see Quality Assurance Head Hospitals.

Analyzes, evaluates, and presents information concerning factors, such as business situations, production capabilities, manufacturing problems, economic trends, and design and development of new products for consideration by other members of management team. Suggests and debates alternative methods and procedures in solving problems and meeting changing market opportunities. Cooperates with other top management personnel in formulating and establishing company policies, operating procedures, and goals. Develops initial and subsequent modifications of product designs to delineate areas of responsibility, personnel requirements, and operational procedures within program, according to and consistent with company goals and policies. Evaluates contents of reports from product assurance program department heads and confers with top management personnel preparatory to formulating fiscal budget for product assurance program. Conducts management meetings with product design department heads to establish, delineate, and review program organizational policies, to coordinate functions and operations between departments, and to establish responsibilities and procedures for attaining objectives. Reviews technical problems and procedures of departments and recommends solutions to problems or changes in procedures. Visits and confers with representatives of material and component vendors to obtain information related to supply quality, capacity of vendor to meet orders, and vendor quality standards. Confers with engineers about quality assurance of new products designed and manufactured products on market to rectify problems. Reviews technical publications, articles, and abstracts to stay abreast of technical developments in industry. [-] Less

Plans, implements, and directs the quality improvement activities of all departments involved in direct patient care and/or services, including medical staff departments, to enhance the quality of service. Reports directly to the CEO or VP of Quality and Patient Services.

Initiates... [+] More

Plans, implements, and directs the quality improvement activities of all departments involved in direct patient care and/or services, including medical staff departments, to enhance the quality of service. Reports directly to the CEO or VP of Quality and Patient Services.

Initiates clinical and service performance improvement projects. Establishes strategic plans, policies, and procedures at all levels with all critical operations departments to ensure quality programs will meet or exceed regulatory requirements. Manages the risk management program to control and minimize risks and losses. Ensures that facility meets all accreditation and regulatory requirements and that best patient care practices are implemented and followed. Monitors service indicators, grievance and appeals data, accessibility and availability of provider network, member and provider satisfaction, and over- and under-utilization of services. Conducts focused chart review audits of medical records and assists with the data collection process. [-] Less

Assists management in the implementation of continuous improvement objectives in the areas of quality, delivery, and cost. Leads teams to execute projects using a variety of continuous improvement tools and methodologies. Leads, coaches, and supports others, including managers and supervisors,... [+] More

Assists management in the implementation of continuous improvement objectives in the areas of quality, delivery, and cost. Leads teams to execute projects using a variety of continuous improvement tools and methodologies. Leads, coaches, and supports others, including managers and supervisors, in their continuous improvement activities.

Assures compliance with established quality standards, National Committee for Quality Assurance standards, and URAC standards when appropriate. Assures the maintenance of accurate documentation of all quality improvement activities, such as surveys, audits, peer reviews, etc. Prepares the agenda and manages the activities of the health plan's Quality Improvement Committees, in conjunction with Medical Affairs. Remains current with new developments in the field of quality improvement. Develops new Quality Improvement activities in the health plan. Oversees the annual Medical Record Documentation/Preventive Services clinical study. Assures that all quality improvement activities are conducted according to CQI and URAC standards and that appropriate data and documentation are kept. Ensures that quality improvement information, including the monitoring and evaluation of indicators, is collected and reported to the Quality Improvement Committee from the various health plan departments, including credentialing, provider relations, health services, customer services. Maintains data collection for HEDIS measures and identifies opportunities for improvement based on the HEDIS results. [-] Less

Directs and manages quality improvement, preventive health, and related departments of the health plan to identify levels and changes in the quality of medical care. Establishes protocols and serves as a resource regarding accreditation standards and continuous quality improvement principles.... [+] More

Directs and manages quality improvement, preventive health, and related departments of the health plan to identify levels and changes in the quality of medical care. Establishes protocols and serves as a resource regarding accreditation standards and continuous quality improvement principles. Designs, develops, and implements quality improvement initiatives necessary for attaining NCQA accreditation. Typically required to be a graduate of an accredited School of Nursing or a Registered Health Information Administrator (RHIA) with a minimum of four years of experience in direct patient care or in administration of health programs.

Develops and implements educational programs for practitioners and enrollees relative to quality improvement, preventive health, early and periodic screening, diagnosis and treatment, and credentialing. Assists in the development of clinical practice guidelines for use by providers. Oversees hiring, developing, and managing a qualified staff concerned with the evaluation of the quality of member care. Implements the organization's policies on quality standards. May work in conjunction with the Medical Director to assess opportunities for improvement and implement changes that will have a positive impact on medical outcomes and compliance with the plan's policies and contractual objections. Prepares and manages the departmental budget. [-] Less

Directs activities related to quality control including strategies, staffing, scheduling, coordinating, quality assurance standards, and planning. Plans, develops, and implements policies, and establishes objectives of all the organization's quality control functions in accordance with organization's objectives. Confers with organization officials... [+] More

Directs activities related to quality control including strategies, staffing, scheduling, coordinating, quality assurance standards, and planning. Plans, develops, and implements policies, and establishes objectives of all the organization's quality control functions in accordance with organization's objectives. Confers with organization officials to plan business objectives, to develop organizational policies, and to coordinate functions. Ensures all areas of organization meet or exceed quality assurance standards.

Recommends new policies or procedures as necessary. Interprets company policy to employees and enforces company policy and practices. Directs assembly of cost control and statistical data and the development of material selection standards. Approves process specification and design standards. Oversees preparation and control of departmental annual budget. May recruit, hire, train staff, evaluate employee performance, and recommend or initiate promotions, transfers, and disciplinary action. May plan and establish engineering schedules and follow up performance against estimates. [-] Less

Provides executive leadership over the hospital’s quality improvement process and programs.

This is not a quality assurance position. Directs the development and implementation of programs and processes related to quality management and performance improvement. Directs and controls quality systems for clinical... [+] More

Provides executive leadership over the hospital’s quality improvement process and programs.

This is not a quality assurance position. Directs the development and implementation of programs and processes related to quality management and performance improvement. Directs and controls quality systems for clinical laboratories. Develops policies and procedures, monitors performance, and develops/reviews metrics for areas of responsibility. Identifies, analyzes, designs, measures, and continuously improves business processes that cut across functional boundaries. Assesses and prioritizes risk, conducts mock inspections, and reports results to senior management. May establish quality improvement project teams. Provides training and guidance to staff to ensure understanding and that quality, accreditation, and performance improvement are actively pursued. Implements processes and methodologies for the identification and sharing of best practices. Develops strategic initiatives and transforms initiatives into action plans. Develops and fosters effective collaboration between departments and other affiliated services to ensure an integrated approach to quality management. Facilitates and coordinates the redesign of processes and systems for improvement with a central focus on patient centered care and services, customer satisfaction, safety, resource efficiency, quality, and employee satisfaction. Develops new strategies to improve overall performance. Hires, develops and motivates a qualified quality management staff. An advanced degree in health care administration is commonly required for this position. The position requires strong clinical and quality management knowledge. [-] Less

Directs the Claims Quality Audit Department and provides managerial oversight to employees engaged in claims auditing and training. Approves department policies, practices, and procedures to ensure identification of claims processing errors. Provides planning, organizing, and budgeting for the department. Typically... [+] More

Directs the Claims Quality Audit Department and provides managerial oversight to employees engaged in claims auditing and training. Approves department policies, practices, and procedures to ensure identification of claims processing errors. Provides planning, organizing, and budgeting for the department. Typically requires a college degree in a related field and an in-depth understanding of claims auditing.

Provides oversight of departmental training and auditing activities. Monitors departmental operations to ensure compliance with regulatory agencies and contractual obligations. Develops strategic initiatives and transforms initiatives into action plans. Hires, trains, and motivates a qualified management staff. Oversees the development of training programs that are targeted toward error reduction and decision quality in claims processing. Analyzes audit and training reports to determine department effectiveness. [-] Less

Supervises and facilitates the coordination and scheduling of all external claims audits conducted by customers, audit firms, external vendors, and regulators. Assists in the preparation of audits and management of the audit process.

Notifies appropriate parties of the audit and schedules... [+] More

Supervises and facilitates the coordination and scheduling of all external claims audits conducted by customers, audit firms, external vendors, and regulators. Assists in the preparation of audits and management of the audit process.

Notifies appropriate parties of the audit and schedules entrance and exit conferences. Develops tools to assist staff in effectively coordinating audits and holds staff meetings as needed. Reviews customer contracts for audit rights, and prepares necessary audit confidentiality agreements and Par Plan addendum agreements. Supervises the obtaining and reviewing of claim samples and documentation. Ensure all HIPAA requirements applicable to the job are met. Directs and oversees analysis of requested data in order to minimize organization's risks. Ensures data integrity. Assures that auditors have a positive experience. Reviews findings and responses for adequacy and appropriateness. Reviews draft and final audit reports from auditors. Prepares responses to report findings. May travel to other claims audit locations as needed. [-] Less