Senior Associate, managing credit risk policy lifecycle at Capital One. Collaborating with stakeholders to ensure compliance and enhance risk frameworks.
About the role
- Risk & Quality Specialist coordinating quality and risk management programs in behavioral health. Collaborate on performance improvement and compliance with regulatory standards.
Responsibilities
- The Risk & Quality Specialist works in collaboration to coordinate, administer and oversee the onsite quality and risk management programs.
- This role will manage, analyze and interpret both risks and performance data to drive key performance measures (KPMs), provides risk and quality education, and comply with Joint Commission standards and other regulatory agencies, with the goal of enhancing and promoting recipient safety, quality of care and minimizing losses to the organization.
- Acts as the Quality Improvement and Risk Management subject matter expert at the site(s), and within committees and associated workgroups.
- Serves as a point of contact for investigation, resolution, and response of internal recipient and external (i.e., Health plan) complaints.
- In addition, may coordinate with the Director of Licensing and Accreditation on responses to complaints received from the Joint Commission or other Regulatory agencies.
- Works with the site-based staff and facilities to ensure all incidents are documented and reported as required to external regulatory bodies.
- Leads initiatives, in collaboration with site leadership and national Quality leadership, that support improvement of organizational processes for clinical care delivery, business operations and administration.
- Works in conjunction with all necessary individuals and departments in the investigation of potential or actual events concerns, including the auditing of seclusion and restraint footage when necessary.
- Coordinates and participates in root cause analysis investigations as appropriate.
- Exercises discretion and independent judgement on identifying opportunities for improvement and driving performance outcomes, this includes identifying opportunities to prevent, reduce, and control loss to the organization, its patients, visitors, and employees.
- Coordinates with leadership to develop strategies, implement practices, and assists with the creation policy to address the identified areas of improvement.
- Coordinates, tracks, and monitors performance and process improvement outcomes, as well as data tracking and trending analysis.
- Completes and documents facility inspections every 6 months, or as needed, to identify areas of risk and/or improvement to ensure compliance with regulatory/accreditation standard.
- Coordinates with the appropriate departments regarding site visits or audit requests from state Health regulatory agencies or accrediting bodies.
- Communication with state regulators, when needed, to inquire about state-specific requirements.
- Assist with creating policies to reflect company vision and mission under direction and in collaboration with department leadership.
- Stays abreast of the latest developments, advancements, and trends in the field.
- Performs all other duties as assigned.
Requirements
- Associate degree, plus one (1) year of experience with Quality and/or Risk in a healthcare setting, or High school diploma, plus (2) years of experience with Quality and/or Risk in a healthcare setting.
- Requires the ability to manage, communicate, and negotiate in challenging situations, with sensitivity to operations and the culture of facility/organization.
- Advanced capability with Microsoft Excel and other reporting software and demonstrated proficiency in using verbal and written skills to clearly communicate complex information to regulators and staff.
- Self-motivated in managing competing priorities in a timely manner.
- State of Arizona Fingerprint Clearance Card.
- It would be nice if you had: Bachelor’s Degree
- 2 years of experience with Quality and/or Risk in a healthcare setting
- Certified Professional in Healthcare Quality
- Expert in Microsoft Excel and/or proficiency with SQL
Benefits
- Employees (and their families) are offered comprehensive health insurance, including Medical, Dental, Vision, Accident, Critical Illness, and Hospital Indemnity
- CHS pays for Basic Life, AD&D, Short and Long-Term Disability
- Voluntary Life insurance option for employees and their families
- Health Savings Accounts (with $1,000 to $2,000 employer contribution depending on plan)
- Flexible Spending Accounts (health care and dependent care)
- 401k company match after 6 months (50% of deferrals up to 6% of compensation)
- Generous PTO starting at 160 hours accrued annually and 12 recognized company holidays
- Employee Assistance Program to help with confidential emotional support, work life solutions, financial solutions, legal assistance, or online support
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