Sr Dir, Quality and Safety Oversight, Clinical Risk Management

In addition to the responsibilities listed below, this position champions enterprise-wide risk management initiatives including cybersecurity, reimbursement model changes, and evolving medical science impacts on hospital performance. The role fosters a culture of continuous learning, defines structures and processes to monitor employee and patient physiological and psychological safety, and leads strategic risk mitigation efforts aligned with organizational goals.

Essential Responsibilities

Builds organizational capacity by developing high-potential talent and fostering internal and external collaboration. Establishes frameworks for performance feedback, coaching, and continuous learning. Leads recruitment, selection, and development of staff; ensures performance management standards align with business needs. Serves as a thought leader on industry trends and best practices, sharing insights across teams. Motivates and empowers teams, aligns cross-functional resources with strategic objectives, and provides guidance on complex decision-making with expanding scope and impact.

Operational & Strategic Oversight

Oversees multiple units and/or departments by identifying operational needs, managing work allocation, and translating business strategy into actionable requirements. Ensures products and services meet member expectations and align with organizational priorities. Engages cross-functional partners to advance business plans, sets performance standards, measures progress, and resolves escalated issues. Analyzes resources, costs, and forecasts to support business planning and removes obstacles to performance. Serves as a trusted advisor and subject-matter expert to executive leadership.

Clinical Quality Improvement & Compliance

Serves as the subject-matter expert for clinical quality improvement regulations and processes for internal and external stakeholders. Provides consultation on policy interpretation, regulatory changes, and long-term compliance strategies. Leads engagement in committees, projects, and initiatives to advance quality assurance (QA) objectives and infrastructure. Builds collaborative partnerships across clinical and administrative roles, influences policy and strategy, forecasts educational needs, and removes barriers to process improvement.

Quality of Care, Risk Management & Patient Safety

Ensures effective management of quality-of-care complaints and review processes, including grievance representation, documentation oversight, and trend analysis to reduce recurrence. Defines standards for quality metrics surveillance, incident tracking, and near-miss reporting. Leads infection prevention and control programs, including outbreak preparedness, surveillance, and executive reporting. Serves as primary contact during significant infection events and advises on infection control implications for facility design and renovations.

Directs enterprise risk management by establishing corrective action standards informed by audits, utilization reviews, and patient feedback. Uses root cause and failure mode analyses to implement risk mitigation policies and procedures. Oversees patient safety programs and serves as the lead during significant events, collaborating with executive management and external partners to improve patient flow, care quality, and satisfaction.

Program Development, Data Strategy & Regulatory Readiness

Leads the development and sustainability of clinical quality improvement programs aligned with long-term strategic goals. Advises on regulatory requirements, clinical quality, and change management to prioritize initiatives that optimize safety and outcomes. Oversees systems and data management processes to monitor performance across worker and patient safety programs, leveraging analytics and health data to guide strategy and executive decision-making.

Serves as the primary contact for regulatory audits and surveys, establishing documentation standards and ensuring continuous readiness. Defines standards for evaluating the cost-effectiveness and appropriateness of care, ensures timely case review follow-up, supports standardized treatment protocols, and advocates for policy and technology improvements informed by utilization and population health data.

Minimum Qualifications

• Minimum four (4) years managing operational or project budgets
• Minimum nine (9) years in a leadership role
• Minimum six (6) years of experience with databases and spreadsheets
• Minimum four (4) years delivering training programs
• Minimum eight (8) years in a clinical setting, health care administration, or related field
• Bachelor’s degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field and minimum nine (9) years of experience OR minimum twelve (12) years of experience in a related field
• Professional Healthcare Quality Certificate or Professional in Healthcare Risk Management Certificate within 24 months of hire

Knowledge, Skills, and Abilities

Negotiation; Business Process Improvement; Risk and Compliance Management; Health Care Policy; Data Analytics; Project Management; Quality Improvement and Assurance; Evidence-Based Medicine; Infection Control; Community Health; Health Care Coding; Consulting; Workforce Development; Risk Assessment.

Preferred Qualifications

• Certified in Infection Control (CIC)
• Active health care clinical license (e.g., RN, RPh, PT, OT, SLP, Social Worker)