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UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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   Current UPMC employees must apply in HR Direct

Director, Quality & Risk Management (Altoona)

Description

Purpose:

Provides leadership and overall direction to the Quality, Risk Management, Regulatory Compliance, Patient Relations and Patient Safety functions of UPMC Altoona

Responsibilities:

  • Make decisions and evaluate outcomes with adequate knowledge, information and consideration of physician stakeholders and members of the all departments.
  • Complete performance reviews to maintain compliance.
  • Develop relationships and integrate all team members including physicians into the team's work. Report program findings, results, and changes at various settings and meetings. Form relationships with various setting in the continuum of care based on program issues/work.
  • Demonstrate a collaborative leadership role in the External Regulatory Survey process, to ensure compliance and continual readiness for accreditation and licensure surveys.
  • Provide leadership and preparation for Regulatory Compliance including DOH Licensure and Joint Commission Accreditation Surveys.
  • Demonstrate responsiveness to the changing priorities and targets in the field of quality and patient safety, and risk management.
  • Implement programs and activities, which support the organization's quality goals. Provide oversight for Pay for Performance Initiatives. Serve as Facility Contact for PHC4.
  • Ensure the systematic management of potential as well as actual claims. Work with Tri Century Insurance Claims Manager to review and determine appropriateness of processing of claims
  • Provide leadership in the ongoing growth of knowledge on quality outcomes.
  • Ensure current and future obligations are met with respect to Public Reporting of quality outcomes.
  • Oversee Quality data analysis and submission. Provide oversight of Quality Dashboard, Report Card and internal databases which serve to track and trend processes and outcomes. Expand dashboard to include unit specific Quality Reports to share with staff using Quality Boards on clinical units.
  • Conduct an analysis of clinical variance trends and recommendations for clinical practice changes. Investigate and implement creative methods to improve process.
  • Act as a resource/consultant for staff and affiliates for questions and concerns regarding professional liability issues. Develop collaborative relationship with UPMC Legal Counsel.
  • Redefine quality measures and process improvement initiatives in conjunction with the needs identified through the internal reporting process. Ensure review and management of RiskMaster through reports and analysis
  • Ensure appropriate External Regulatory Reporting including reporting of Serious and Sentinel Events, Disclosure Letters and reporting to FDA under MedWatch. Develop relationships with DOH Surveyors to encourage collaboration and communication. Serves as facility contact for the Joint Commission and PA Dept of Health.
  • Assume leadership role in the development of process improvement opportunities related to changes in clinical practice to support organizational goals. Apply innovative and creative skills to ensure that the process improvement opportunities are identified and addressed as well as meet the needs of quality, risk and safety goals, and meets regulatory guidelines.
  • Work collaboratively with the Director of Medical Staff Office and the V.P.M.A. Quality to provide Peer Review data to facilitate appropriate reviews and improvements as well as to support TJC OPPE and FPPE.
  • Responsible for ensuring implementation of a Patient Relations Program in accordance with the Complaint Process and Grievance Policy.
  • Serve as the senior internal consulting resource for clinical measurement, analysis and reporting.
  • Collaborate with professionals across the UPMC Altoona and the UPMC Health System to identify and support joint educational opportunities to change clinical practice. Active participation on Health System Committees.
  • Recommend changes to policies and procedures to senior leadership. Participate with system Policy and Procedure Committee and the revisions and improvements to the process.
  • Develop, implement, or utilize appropriate existing local data management capability that supports clinical program initiatives, decision support and regulatory compliance.
  • Oversee the Risk Management Program.
  • Provide administrative leadership and overall direction to the Quality, Risk, Patient Safety, and Patient Relations Departments for UPMC Altoona. Provide oversight of same at UPMC Bedford.
  • Manage all human and financial aspects of the department to assure that standards for quality and cost effectiveness are met. Prepare annual man-hours, expense and capital budget for responsible cost centers based on an analysis of needs of patients, clinical programs, staff and physicians.
  • Ensure budgetary standards/expectations are met by monitoring and maintaining expenses and man-hour utilization.
  • Responsible for the Patient Safety Officer for the facility and accepts responsibility for promoting patient safety, education on patient safety and the investigation and reporting of any adverse events.
  • Effectively participate and engage in activities to support and achieve organizational strategic goals including an analysis of quality programs and patient care outcomes. Demonstrate an interactive leadership style that influences thinking and reshapes the quality environment.
  • Lead multidisciplinary teams, as assigned, in the development and ongoing progress of clinical outcomes to achieve organizational objectives of reducing resource utilization while promoting quality patient outcomes.
  • Demonstrate initiative to address complex, high-risk problems and translate them into opportunities and challenges with all levels of management.
  • Analyze data and claim history to identify opportunities to improve the quality of patient care while controlling liability exposure.
  • Coach and advise professional staff in the formulation of their development plan.
  • Primary oversight for Core Measures- ensuring accurate data collection, reporting of outcomes and improvements in process.
  • Section 504 of the Rehabilitation Act of 1973 prohibits discrimination on the basis of disability by recipients of Federal financial assistance. The Section 504 Coordinator ensures that UPMC complies with all provision of this law.
  • Facilitates the implementation of the UPMC approved Section 504/ADA policy.
  • Educates relevant stakeholders at the hospital about the UPMC Section 504/ADA Grievance Policy.
  • Develops and implements consistent Section 504/ADA grievance procedures at the hospital.
  • Coordinates Section 504/ADA /ADA grievance procedures with relevant stakeholders.
  • Develops a hospital process for ensuring that all clinical departments and relevant personnel understand how to obtain assistive communication devices and other disability accommodation resources. 
  • Provides ongoing training and support to UPMC staff regarding Section 504/ADA and the implementation of the Section 504/ADA procedures.
  • Collects and maintains all Section 504/ADA grievance data.
  • Monitors architectural barriers for individuals with disabilities and reports those barriers to the relevant personnel.
  • Facilitates the provision of reasonable accommodations for UPMC patients and employees with disabilities.
  • Ensures that his/her business unit has a process for obtaining interpreters and auxiliary aids that works and is understood by the personnel at his/her facility and also has the responsibility for monitoring that process and the equipment periodically.
  • Serves as a liaison between the Disabilities Resources Center, facility's disability champion, patient relations representative, human resources and other UPMC staff regarding Section 504/ADA issues.
  • Serves as a resource to the UPMC Disability Resources Center regarding Section 504/ADA issues.
  • Serves as the hospital's liaison to the Office for Civil Rights. (OCR complaint resolution and corrective action plan implementation).
  • Advises the Disabilities Resources Center and the UPMC Chief Quality Officer 

 

Qualifications

 Qualifications

  • Master's Degree required
  • 7-10 years Healthcare Related Experience required, with 5-7 years Supervisor Experience preferred
  • Certification in related area of expertise preferred. Knowledge of various aspects of quality and process improvement through IHC, IHI, Lean Systems management and other techniques.
  • Experience in Risk Management strategies, preparation for litigation and claim management
  • Experience in effective presentation of quality efforts to medical professionals of multiple disciplines
  • Excellent interpersonal skills and demonstrated Leadership qualities- (prefer Beckwith Fellowship or Leadership Development Intensive or other comparable areas of study)
  • Knowledge of Nursing and Other Clinical Practices Knowledge of regulatory requirements of multiple accrediting organizations including TJC, DOH and CMS
  • Understanding of Peer Review Process including TJC OPPE and FPPE Magnet or Baldrige experience preferred

 

Licensure, Certifications, and Clearances:

RN (clinical/operational experience preferred). CPHQ (Certified Professional in Healthcare Quality) or CPHRM (Certified Professional Healthcare Risk Manager) or CJCP (Certified Joint Commission Professional) preferred.

  • Registered Nurse (RN)

UPMC is an Equal Opportunity Employer/Disability/Veteran

COVID-19 Vaccination Information

Individuals hired into this role must comply with UPMC’s COVID vaccination requirements upon beginning employment with UPMC. Refer to the COVID-19 Vaccination Information section at the top of this page to learn more.

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

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