Quality Management Specialist

Quality Management SpecialistDrives clinical excellence by identifying risks and opportunities to improve the quality, safety, and outcomes of patient care at the functional unit, department, and hospital levels. Applies clinical expertise, professional judgment, and quality management principles to support performance across quality, safety, regulatory, accreditation, and outcomes measures, including metrics that impact publicly reported rankings, organizational reputation, and performance-based reimbursement. Conducts medical record reviews, identifies opportunities to improve care and adherence to best practices, facilitates Medical Peer Reviews and Ongoing Professional Practice Evaluations (OPPE), and analyzes, monitors, and reports quality data to support regulatory requirements, accreditation standards, quality improvement initiatives, and Pay-for-Performance programs.The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job responsibilities performed.Applies clinical knowledge, professional judgment, and healthcare quality principles to support quality improvement, patient safety, regulatory compliance, accreditation, performance improvement, and outcomes management activities.Collaborates with interdisciplinary teams to develop, implement, and evaluate quality improvement initiatives that enhance clinical outcomes, patient safety, reliability, and care delivery processes.Supports quality and safety improvement initiatives aligned with organizational priorities, including mortality reduction, sepsis performance, Patient Safety Indicators (PSIs), performance-based reimbursement programs, Potentially Preventable Complication/Maryland Hospital Acquired Condition (PPC/MHAC) reduction, CMS quality measures, publicly reported outcomes, hospital rankings, and regulatory requirements.Utilizes available data sources to collect, analyze, benchmark, and interpret quality and performance data; identifies trends, risks, and improvement opportunities; exercises independent judgment in evaluating findings and developing recommendations for corrective action and process improvement; and communicates findings and recommendations to the leadership and other stakeholders.Identifies, investigates, and escalates quality, patient safety, and clinical performance concerns and collaborates with operational and Medical Staff leaders to develop and monitor corrective action plans, as appropriate.Works directly with physicians, nursing leaders, and operational leaders to monitor performance, implement improvement strategies, and sustain measurable improvements.Participates in Quality Assessment and Performance Improvement (QAPI) activities, including the planning, implementation, monitoring, and evaluation of organizational performance improvement initiatives.Participates in root cause analyses, patient safety event reviews, regulatory readiness activities, and follow-up actions to address identified quality and safety concerns.Conducts retrospective chart audits and medical record reviews to identify clinical, documentation, and process improvement opportunities and shares findings with relevant stakeholders.Partners with Medical Staff Chairs and Peer Review Committee Chairs to facilitate departmental Peer Review processes that promote quality improvement, patient safety, accountability, and professional development.Facilitates Ongoing Professional Practice Evaluation (OPPE) activities for assigned Medical Staff service lines, including data collection, indicator analysis, performance monitoring, and report preparation for Medical Staff leadership.Prepares, analyzes, and monitors quality reports and performance metrics to support regulatory requirements, accreditation standards, quality improvement initiatives, and Pay-for-Performance programs.Supports the development, implementation, and evaluation of Quality Management department goals, strategies, and key initiatives.Perform all other duties as assigned.Education & Experience - RequiredBachelor's degree or higher in a healthcare-related field required.Graduate of an accredited clinical professional program required (e.g., Registered Nurse (RN), Physician Assistant (PA), Physician (MD/DO), Pharmacist (RPh/PharmD), Respiratory Therapist (RT), Occupational Therapist (OT), or other clinically licensed healthcare professional).Minimum of two (2) years of clinical, healthcare quality, patient safety, performance improvement, or related healthcare experience.Working knowledge of healthcare quality improvement principles and methodologies.Education & Experience - PreferredCertified Professional in Healthcare Quality (CPHQ) or other relevant quality, patient safety, risk management, or performance improvement certification.Current licensure in Maryland as a Registered Nurse (RN).Experience with Maryland's quality-based reimbursement programs, hospital quality incentive programs, and value-based payment initiatives.Previous experience in healthcare quality management, risk management, patient safety, performance improvement, or accreditation and regulatory compliance.Experience with Medical Staff Peer Review, Ongoing Professional Practice Evaluation (OPPE), quality analytics, and performance reporting.Experience applying quality improvement methodologies such as PDSA, Lean, Six Sigma, Root Cause Analysis, or similar approaches in a healthcare setting.Additional InformationAll your information will be kept confidential according to EEO guidelines.Compensation:Pay Range: $42.64/hr-$64/hrOther Compensation (if applicable): Review the 2025-2026 UMMS Benefits Guide