Quality and Safety Improvement Consultant IV (KFH/HP)

Facilitates a broad range of administrative, facilitation, and technical support functions in the area of Quality and Safety Improvement to support Quality and Safety programs and initiatives. Develops, implements, monitors, and continuously improves Quality and Safety programs and initiatives. Develops and monitors performance indicators and metrics, collaborates with appropriate departments to collect, analyze, and trend data from multiple reporting systems and sources to identify opportunities to improve quality and safety, decrease risk, and maintain the KP safety culture. Develops and coordinates across workgroups to address priority issues and acts as a resource for issues related to quality and safety. Supports multiple committees that are coordinated or chaired by the department. Contributes to the organizations compliance with professional standards, laws and regulations, and internal requirements related to quality and safety.

Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome. Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions. Conducts data extraction, analyses, and presentations to support quality improvement efforts by: conducting statistical analysis to determine the reliability and confidence intervals for quality improvement evaluations and special projects; creating charts, graphs, and narrative summaries of improvements utilizing multiple data reporting systems; presenting quality improvement metric reports at the individual and team level to demonstrate improvements and effectiveness of quality improvement programs into specified formats; and documenting and analyzing trends, potential errors, and other analysis and reporting finds to the supervisors. Facilitates quality improvement and improvement risk management efforts by: assisting with the development of corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials, member satisfaction surveys, and auditing surveys; ensuring process improvements are compliant with established internal and external regulation requirements at the local level; conducting 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 exercising independent judgment to escalate high-risk issues and trends to appropriate entity for resolutions.