Director of Quality and PI, Healthcare Quality & Compliance
Overview
The role owns quality, risk, and performance improvement across the facility operating at scale. Lead regulatory compliance with CMS, TJC, and CARF standards while driving data-driven improvement and patient safety culture. Collaborate with Legal, Compliance, and HR to ensure policy adherence and staff accountability. Be the primary liaison during surveys and audits and provide mentorship to staff.
What You'll Do10
- 1Build the QAPI program and monitor KPIs to govern data-driven improvements
- 2Lead quality, risk and client safety strategy across inpatient and outpatient services
- 3Oversee incident reporting, RCA analysis, and risk mitigation to prevent recurrence
- 4Maintain survey readiness and serve as liaison during regulatory surveys and reporting
- 5Provide staff training and leadership rounds to ensure competency and adherence to standards
- 6Supervise Patient Advocate/Coordinator roles and support governance meetings and audits
- 7Serve as Patient Safety and Compliance Officer and oversee privacy and security considerations
- 8Develop and implement new programs in response to market needs and ensure policy alignment across departments
- 9Collaborate with Legal, Compliance, and Risk Management on high risk events and corrective actions
- 10Support environment of care and documentation standards through ongoing monitoring
Requirements5
- 1Bachelor’s degree with clinical nursing or business emphasis
- 2Three years’ experience in quality, client safety, regulatory compliance, risk management, or related behavioral health fields
- 3Knowledge of CMS, Joint Commission and CARF standards
- 4CPHQ preferred or equivalent qualifications
- 5CPR and de-escalation and restraint certification required
Salary Insight
Salary not disclosed in listing
Location
Required Skills
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