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InterMed, P.A. · 1 day ago

Risk & Quality Assurance Specialist | Full-Time | South Portland, ME

South Portland, ME

Full-time

Onsite

Mid Level

3+ years exp

InterMed, P.A. is committed to providing patient-centered primary care and is seeking a Risk & Quality Assurance Specialist. This role involves supporting risk management, patient safety, and quality assurance initiatives to enhance patient outcomes and operational efficiency.

Health CareMedical

Responsibilities

Support the identification, evaluation, and mitigation of risks related to patient safety, clinical care, and regulatory compliance to protect patients and reduce liability within the organizations

Manage the investigation of adverse patient outcomes, quality of care opportunities and patient safety events to assess potential harm, identify root causes, and coordinate appropriate follow-up actions, as assigned by the department Director

Identify and escalate adverse events, complaints and grievances that may lead to potential claims in a timely manner

Manage the investigation of verbal and written complaints and grievances involving quality of medical care and services

Independently research of medical records, interviews with involved parties, documentation of findings, formulation of responses, and facilitation of resolution whenever possible

Apply techniques of problem solving, active listening, negotiation, conflict resolution, diplomacy, and diffusion of emotions in investigating and addressing adverse events, complaints and grievances

Negotiate and mitigate expectations to promote satisfaction, ensure quality and safety and minimize the risk of adversarial outcomes

Provide planned, as well as just in time, education related to customer service, conflict resolution, and effective tools for establishing interpersonal connections with patients and families

Support the development and implementation of standard operating procedures related to risk management, patient safety and quality assurance

Partner with clinical and operational leaders, the ASC directors and care teams to embed safety and risk mitigation strategies into workflows

Support development of a safe and just culture by supporting frontline staff and clinical leaders in safety reporting and response efforts

Support the facilitation of safety and risk education for clinical and administrative staff, including orientation and ongoing training

Review and report on patient experience measures

Develop and support implementation of performance improvement plans related to patient experience measures

Benchmark performance against industry standards and best practices

Support the development and execution of ASC Quality Assurance and Performance Improvement (QAPI) Program Annually

Support the development and execution of the ASC Risk Management Program Annually

Assist in tracking and reporting required measures as outlined in the Medicare Ambulatory Surgical Center Quality Reporting (ASCQR) program

Assist in conducting medical record reviews in alignment with the ASC policies to ensure ongoing compliance with documentation requirements

Participates in activities that support ongoing readiness for regulatory and accreditation surveys

Assist in the development and implementation of quality improvement initiatives to enhance patient outcomes and operational efficiency

Collaborate with healthcare teams to promote evidence-based practices and continuous improvement

Maintain current knowledge of healthcare regulations, accreditation standards, and industry trends

Assist in the creation and implementation of quality management systems to support consistent and safe clinical practices

Support operational teams to ensure provision of safety patient care and risk mitigation

Maintains strict confidentiality in alignment with HIPAA (Health Insurance Portability and Accountability) guidelines and InterMed policies

Perform other duties to support the mission, vision and values of InterMed

Qualification

Healthcare Risk ManagementPatient SafetyQuality AssuranceCertified Professional in Healthcare Risk ManagementCertified Professional in Patient SafetyHealthcare AdministrationConflict ResolutionActive ListeningNegotiationTeamwork

Required

Bachelor's degree in healthcare administration or equivalent combination of experience and education required

3-5 years healthcare, clinical quality, patient safety, and/or risk management experience required

Certified Professional in Healthcare Risk Management (CPHRM) or Certified Professional in Patient Safety (CPPS) required, or ability to obtain certification within 1 year of hire