RN Quality & Safety Oversight Specialist V, Clinical Quality Oversight
Walnut Creek, CaliforniaAt Kaiser Permanente our nurses are leaders, clinicians, researchers, innovators, and scientists who are contributing toward being an industry-leading voice for advancing evidence-based care. Whether supporting the patient directly in our hospitals or clinics, providing care at home, serving our patients through innovative virtual technology, or managing care delivery teams, Kaiser Permanente nurses utilize scientific evidence and our integrated care model to optimize the total health of our members and the communities we serve. We invite nurses who are passionate about nursing excellence, high-quality compassionate care delivery, professionalism, integrity, teamwork and patient and family centeredness to join our teams so that we can continue to sustain and build upon our culture of excellence.
- Job Type: Full-time
- Job Level: Individual Contributor
- Travel: Yes, 10 % of the Time
Success Profile
We’re looking for Nurse Leaders who possess the following traits.
- Collaborative
- Compassionate
- Flexible
- Leadership
- Socially Conscientious
- Trustworthy
Benefits
We offer several benefits to our nurses.
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Medical, Vision & Dental
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Retirement Plans
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Educational Opportunities & Tuition Reimbursement
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Supportive Teams & Resources
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Career Growth & Development
Our Culture
At Kaiser Permanente, we cultivate an environment of compassion, integrity, trust, and open communication that helps our teams do their best work. We believe that lifelong learning will expand our knowledge so we can better serve our patients. Our practice is rooted in research and evidence-based care. Our nurses reflect the rich diversity of our members and communities and provide culturally responsive and competent care that promotes understanding of our members needs and preferences. At Kaiser Permanente, nurses are highly skilled professionals who exemplify leadership, critical thinking, and collaborative problem solving and deliver the right care, at the right time, in the right setting.
What Our People Are Saying
Kristen
Relief Charge Nurse
“Working as a nurse at Kaiser Permanente has allowed me the perfect flexible schedule so that I can volunteer as Girl Scout Leader and room parent for both my children. My kids know that I am a hardworking mother who can provide, as well as a mom who can be present and be there for them – and that means everything to me.”
Jazmin
RN, Advice Nurse
“Working for Kaiser Permanente has allowed me to take control of my future and make my goals a possibility. I feel that Kaiser Permanente allows me to keep climbing and moving. Having that ability truly makes me feel empowered.”
Stella
Registered Nurse IV
“Kaiser Permanente has taken me on a personal and educational growth journey. I am supported by a culture of excellence that allows me to be dedicated to patients and patients’ families every day at work. What an honor to be part of Kaiser Permanente.”.
Caitlin
Inpatient Lactation Consultant
“As an RN/IBCLC in Maternal Child, I’m meeting families at a pivotal time — I’m there to help launch a new family into the world. Everything I do has the potential to impact a family’s health for generations to come.”
Kimberly
Quality Coordinator RN
“In Hawaii, your community is your family — or ‘ohana.’ I am able to provide extraordinary patient-centered care to my ohana.”
David
Appointment and Advice RN
“The location is fantastic. Kaiser Permanente is all over the country. You can pick almost any environment you want – from ocean to mountain to city. You’ll still be able to contribute to our mission of providing high quality health care at a local facility.”
Shawn
BSN, RN
“I chose Kaiser Permanente because their staff and providers really show that they care about you. Also, throughout my 12 years of working here I’m always learning something new, and I’ve had many opportunities for growth and development.”
RN Quality & Safety Oversight Specialist V, Clinical Quality Oversight
Primary Location Walnut Creek, California
Worker Location Flexible
Job Number 1323985 Date posted 12/09/2024
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Description:
In addition to the responsibilities listed above, this position is also responsible for partnering with the Board of Directors in providing oversight of systems designed to monitor and ensure the quality care and services are provided at a comparable level to all members and patients across the continuum of care; serving as a point of escalation for complex issues in quality improvement systems; proactively identifying and communicating issues related to the organization meeting the standards established by regulatory agencies and accreditation organizations and meeting public expectations; ensuring the integrity of systems related to the selection, credentialing and competence of physicians and other health care practitioners; monitoring systems for granting or terminating clinical privileges, professional staff or medical staff or clinical staff membership, proctoring and continuing education; reviewing and approving medical staff or provider staff Bylaws, Rules and Regulations and amendments; and managing the oversight of systems of all contracted entities including but not limited to the Permanente Medical Groups. This role is also responsible for leading the peer review process, committees, and forums through evaluating and integrating direct information on hospital or health system performance; developing comprehensive feedback; and refining and communicating a strategic development plan to address needs and solve problems.
Job Summary:
In addition to the responsibilities listed above, this position is also responsible for partnering with the Board of Directors in providing oversight of systems designed to monitor and ensure the quality care and services are provided at a comparable level to all members and patients across the continuum of care; serving as a point of escalation for complex issues in quality improvement systems; proactively identifying and communicating issues related to the organization meeting the standards established by regulatory agencies and accreditation organizations and meeting public expectations; ensuring the integrity of systems related to the selection, credentialing and competence of physicians and other health care practitioners; monitoring systems for granting or terminating clinical privileges, professional staff or medical staff or clinical staff membership, proctoring and continuing education; reviewing and approving medical staff or provider staff Bylaws, Rules and Regulations and amendments; and managing the oversight of systems of all contracted entities including but not limited to the Permanente Medical Groups. This role is also responsible for leading the peer review process, committees, and forums through evaluating and integrating direct information on hospital or health system performance; developing comprehensive feedback; and refining and communicating a strategic development plan to address needs and solve problems.
Essential Responsibilities:
- Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit. Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams.
- Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals. Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
- Serves as the subject matter expert for clinical quality improvement processes and regulations practitioners, Quality Specialists, department managers, and peers, projects/committees, and internal stakeholders by: providing consultation on the interpretation and interaction of current policies, and how they interact with the current climate, and potential changes to regulations and legislation; serving as a technical advisor on committees, projects to drive discussions on drawing guidelines on the enforcement, development of policies or procedures of regulations and auditing processes; maintaining collaborative, results oriented partnerships with practitioners and/or staff across clinical and administrative roles to ensure compliance with regulations and improve patient safety, reporting accuracy, and health outcomes and provides insight to the regulation climate; developing educational programs to raise awareness for current and changes in regulation requirement, internal concerns, and system/database usage; and anticipating issues, weighing practical and technical considerations in addressing issues, and coordinating with the appropriate stakeholders to develop resolutions.
- Develops the quality of care complaints and the review process by: coordinating grievance meetings, cases, reviews, referrals, or other mechanisms by collaborating with the ombudsman and external regulatory services; responding to and directing the preparations of all documentation, records, and information requested for specific patient case reviews; ensuring consistent follow through on quality of care concerns and analyzing and managing the process flow of investigations and claims for potential errors, red flags, and areas of improvement; and monitoring critical quality improvement metrics, cases, quality care incidents, and near misses according to established protocols on an ongoing basis.
- Develops risk management efforts by: researching corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials, patient satisfaction surveys, and auditing surveys; serving as a subject matter expert for internal and external policies, regulations, scientific research, and legislation related to quality improvement; conducting complex root cause analysis, failure mode and effect analysis, and other assessments in response to significant events, near misses, and good catches in order to identify areas of improvement and evaluate newly internalized processes and programs; and exercising independent judgment to escalate high-risk issues and trends to appropriate entity for resolutions.
- Provides consultation for the development of new clinical quality improvement programs by: consulting with teams and departments to develop guidelines, metrics, and operational definitions of quality improvement through qualitative and quantitative program evaluation, analyzing program performance, and peer/department review groups by challenging groups to provide creative solutions; leveraging a variety of health concepts, regulatory requirements, and change management principles to develop programs which optimize clinical quality, safety, or health outcomes; and researching and investigating innovative opportunities to develop KPs capacity as a learning organization, increasing capacity in areas such as video ethnography, patient-reported outcomes, and harvesting of best practices.
- Develops and implements systems, procedures, and forms to improve data management programs and utilizes data to monitor and improve performance of all worker and patient safety programs by: ensuring the quality improvement monitoring agenda for assigned departments includes all aspects of data management and analysis of trends and patterns of practice; conducting descriptive inferential, reliability, and confidence intervals statistical analysis for routine and special projects related to quality improvement evaluations; developing the procedures for gathering and entering data from databases, vital statistics, hospital patient discharge data, claims, and other relevant health sources; and analyzing and presenting reports (e.g., infection control research, utilization reviews, population health needs analysis, patient satisfaction) into specified formats for internal stakeholders and working with departments to develop action plans.
- Develops the process for regulatory audits and survey efforts by: serving as a liaison between external evaluators, vendors, and departments for onsite visits and evaluations; delivering ad hoc and complex requested audit documentation, information, reports, and tools throughout the auditing process; assessing the workflow of completing auditing surveys to identify gaps in completion and reporting; and conducting routine mock audits and surveys within departments to ensure auditing and survey preparedness.
- Seeks and addresses feedback from the evaluation of the cost effectiveness, practicality, and appropriateness of medical care given to patients by: creating the reports to be used in complex case reviews with senior leaders and practitioners; analyzing current standard operating procedures for treatment for specific medical codes to ensure equal and timely access to care and escalates concerns or improvements to senior leaders; analyzing current patient treatment plans to ensure patient needs are met in a timely manner and escalates issues to senior leaders; leading discussions with practitioners, staff, and patients to identify population health needs, such as community health concerns, access to transportation, knowledge of rights, reducing no shows, and others, and providing recommendations to senior leaders; and analyzing previous patient cases to identify areas of improvement for length of stay, type of treatment, and time of treatment, and reporting recommendations to the Manager.
Minimum Qualifications:
- Minimum three (3) years of experience in a leadership role with or without direct reports.
- Minimum three (3) years of experience with databases and spreadsheets.
- Minimum three (3) years of experience delivering training programs.
- Minimum four (4) years of experience in clinical setting, health care administration, or a directly related field.
- Bachelors degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field AND Minimum five (5) years of health care experience or a directly related field OR Minimum eight (8) years of experience in health care or a directly related field.
Additional Requirements:
- Knowledge, Skills, and Abilities (KSAs): Business Process Improvement; Risk Management; Compliance Management; Health Care Data Analytics; Learning Measurement; Consulting; Managing Diverse Relationships; Delegation; Development Planning; Project Management; Health Care Quality Standards; Quality Improvement; Quality Assurance and Effectiveness; Evidence-Based Medicine Principles
Preferred Qualifications:
- Certified Professional in Healthcare Quality (CPHQ).
- Certified Joint Commission Professional (CJCP) or credential(s) from the Healthcare Accreditation Certification Program(s) (HACP).
Primary Location: California,Walnut Creek,501 Lennon Lane
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 08:00 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Flexible
Employee Status: Regular
Employee Group/Union Affiliation: NUE-NCAL-09|NUE|Non Union Employee
Job Level: Individual Contributor
Specialty: Quality & Safety Oversight
Department: Oakland Reg - 1950 Franklin - Rgnl Health Plan Quality - 0208
Pay Range: $155200 - $200750 / year
Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.
Travel: Yes, 10 % of the Time
Flexible: Work location is on-site at a KP location, with the flexibility to work from home.
Worker location must align with Kaiser Permanente's Authorized States policy.
At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. Submit Interest
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. Submit Interest
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