Quality Improvement Specialist

Applies advanced knowledge and experience as a seasoned Quality Improvement (QI) Specialist to projects of moderate to high complexity, independently managing quality improvement initiatives through the application of data analytics, project management, and quality improvement methods (e.g. LEAN, A3 thinking). The Quality Improvement Specialist will provide quantitative and qualitative programmatic support to the Department of Medicine and its Divisions, with a dedicated 50% effort supporting the Division of Hospital Medicine at Zuckerberg San Francisco General Hospital (ZSFG).

The incumbent will partner with clinical, operational, and administrative leaders to design, implement, evaluate, and sustain quality improvement initiatives that improve patient care and health system performance. A core responsibility of this position is transforming complex clinical and operational data into actionable information to support quality improvement.

Using statistical software programs, the incumbent will acquire, integrate, clean, and manage data from multiple hospital and administrative data sources; develop analytic datasets; create meaningful quality measures and derived variables; perform descriptive and exploratory analyses; and produce reports, dashboards, and data visualizations to inform improvement efforts.

The incumbent will work with imperfect and evolving data, applying sound data analytic methods and judgment to ensure data quality and interpretability. In addition, the incumbent will support strategic planning, program oversight, and implementation of departmental and divisional quality initiatives by identifying analytic and operational needs, monitoring project performance, evaluating outcomes, and providing consultative support to clinical teams.

This position will collaborate closely with partners across inpatient and outpatient settings to align quality improvement efforts across the continuum of care. The successful candidate must be able to manage multiple concurrent projects, communicate analytic findings effectively to diverse stakeholders, exercise independent judgment, and maintain exceptional attention to detail in a fast-paced environment.

NOTE: This is NOT a remote position, and it requires the incumbent to be on-site at least 2 days per week. No relocation assistance will be provided. % of time Essential Function (Yes/No) Key Responsibilities 50 Yes Quality Improvement Processes Supports DOM and its Divisions in clinical data management including establishing systems for data acquisition and dashboard development.

Designs data reporting structures to support quality reviews for new clinical and operational quality initiatives. Develops and implements systems, policies and procedures, and data collection and reporting tools to measure and analyze performance standards and outcomes. Researches best practices and develops proposals for improvements in the data collection and reporting processes and / or systems.

Establishes new quality and performance metrics to enhance reporting and evaluation. Works with leadership to systematically track, analyze and follow up on quality and safety events affecting the division. Identifies statistical trends, and potential issues in patient care and services. Works collaboratively on highly complex projects in assigned clinical areas to develop corrective plans, and monitor their effectiveness.

Conducts weekly Epic metrics reviews, identifying and resolving discrepancies and providing actionable reports to key stakeholders. 35 Yes Data Analytics and Management Supports designated clinical areas on data management including establishing systems to acquire data. Works with multiple stakeholders and leadership internal and external to Divisions and the Department.

Develops appropriate data reporting structures to support quality reviews. Collates data relevant to quality improvement from a variety of sources. Analyzes and interprets complex datasets and summarizes statistical findings for decision-making using statistical software programs. Develops reports, dashboards, presentations, and action plans to translate data into actionable insights.

Contributes to development of executive summaries, drafting key portions as needed. 10 Yes Strategic Planning, Consultation, Engagement and Programmatic Support Provides advice and recommendations on complex clinical QI issues of functionality, efficiency, and program development. Provides strategic consultation in partnership with various Department and Divisional leadership for the development of new quality and safety initiatives and/or refinement of existing ones.

Guides QI efforts using Lean tools and A3 thinking, ensuring a structured and effective approach to process improvement Builds and maintains strong collaborations with ZSFG clinical leaders and QI personnel to align quality improvement efforts across teams Performs timely and accurate reporting of quality data to appropriate internal departments and outside agencies.

5 Yes Other duties as assigned 100% Required Qualifications: Bachelor's degree in a healthcare profession, business or healthcare administration, or a combination of comparable clinical education and three or more years of relevant experience and / or experience. High proficiency with MS Excel and working knowledge of Microsoft Office, PowerPoint, Access, and software tools for organization, scheduling, correspondence, data collection, analysis, and reporting.

Detail-oriented, with proven ability to effectively manage time, see projects through to completion, organize competing priorities, and effectively address complex, urgent issues as they arise. Strong critical thinking and problem solving skills to manage multiple levels of information and responsibilities, to quickly assess complex problems, and to develop and implement timely and effective solutions.

Strong interpersonal skills, and written and verbal communication skills for collaborating effectively with a broad range of clinical and technical staff and representatives of external regulatory agencies and for mentoring lower-level QI staff. Strong skills required to effectively convey complex clinical and technical information both verbally and in writing and to produce high quality reports and documentation.

Thorough knowledge of QI standards, clinical chart review and abstraction, and regulatory requirements. Thorough knowledge of QI models, measurement tools, and techniques, including collection, aggregation, abstraction, validation, analysis, and reporting of data. Intermediate proficiency in the use of statistical software programs (SAS, STATA or R) in order to acquire, merge, clean, validate, and transform data from multiple clinical and administrative sources; construct analytic datasets; derive quality measures and variables; and conduct descriptive statistical analyses to support quality improvement initiatives.

Experience working with Epic (or other EHR) data extraction and analyses.

Preferred Qualifications

Master's degree in public health, health administration, business, or a combination of comparable education/experience. Strong skills to influence staff, management, and clinicians at all levels and across departments.