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Coordinator Regulatory - Full-time, Day shiftReq #:0000152460

Category:Clerical / Administrative Support

Status:Full-Time

Shift:Day

Facility:RWJ Somerset

Department:External Affairs and Policy

Location:

RWJUH Somerset, 110 Rehill Ave, Somerville, NJ 08876

Coordinator Regulatory Job Responsibilities:

• Helps coordinate under the direction of the Director, Quality, Safety & Regulatory, the hospital's regulatory readiness processes to assure compliance with regulations and standards of regulatory and accreditation agencies,

• Monitors compliance of the standards and works in collaboration with the departments to implement performance improvement/regulatory initiatives,

• Assists departments with development of performance improvement/regulatory indicators and analyzes the data collected,

• Performs survey readiness tracers and provides feedback to the department for follow up,

• Assures that meetings are scheduled, agendas are prepared and minutes are completed in a timely manner,

• Provides education as requested regarding quality, regulatory and performance improvement initiatives at new employee orientation, physicians' orientation, or other hospital forums as needed,

• Provides ongoing information and education on changes and updates to Joint Commission, CMS, and Department of Health Standards and other agencies requirements,

Quality Reviews

• Coordinates quality reviews and responses on NJDOH and Joint Commission patient complaints

• Coordinates root cause analysis on reportable events defined in the New Jersey Patient Safety Act, and coordinates intensive analysis of other patient safety events as needed.

• Ensures action plans are implemented and monitoring is conducted,

• Conducts one annual RCA on a near miss

Policies and Procedures

• Co-chairs the hospital policy and procedure committee and assists with maintaining the online policy and procedure system

• Assists with scheduling meetings, preparing agendas and minutes in a timely manner,

Online Event Reporting System

• Reviews reported events for potentially meeting reporting requirements for the Patient Safety Reporting System,

Completes special projects for Executive Leadership/Director of Quality, Safety & Regulatory in a professional manner, as evidenced by the following:

• Project is completed according to the established guidelines and time frames of the requesting party,

• Effective time management skills are used to ensure that projects are completed without jeopardizing normal daily work requirements,

• Careful research and investigation is done so that data being used are accurate and up to date,

Requirements:

Education:

• Bachelor s degree in healthcare related field required;

• Master s degree preferred.

• RN License in New Jersey desirable.

• Professional Certification (CPHQ-Certified Professional in Healthcare Quality, or CPPS-Certified Professional in Patient Safety) highly desirable.

Experience:

• Minimum of five years experience in clinical practice.

• Knowledgeable about state, federal, and regulatory agency requirements.

Personal Qualifications:

• Ability to work effectively with colleagues, physicians and hospital staff.

• Ability to effectively and efficiently organize, prioritize, and coordinate job responsibilities.

• Outstanding verbal and written communication skills.

• Strong leadership skills

RWJBarnabas Health is an Equal Opportunity Employer