Quality and Regulatory Affairs Specialist, Mount Sinai ...

Strength Through Diversity.Ground breaking science. Advancing medicine. Healing made personal.Roles & Responsibilities:Quality and Regulatory Affairs SpecialistThe Quality and Regulatory Specialist facilitates and participates in the implementation of the multidisciplinary hospital and system wide Clinical Quality and Patient Safety Performance Improvement Program. This is a healthcare professional who coordinates the planning, monitoring and evaluation of the Quality and Regulatory Readiness program.Participates in planned and unplanned regulatory visit activity.Promotes collaborative practice among departments/services for improved clinical outcomes, processes of care and regulatory compliance.Facilitates the identification of opportunities for improvement and assist in the design and ongoing measurement of performance indicators and outcomes as part of the Clinical Quality and Patient Safety Performance Improvement Program.Assists in planning, reviewing, and implementing activities related to the organizational goals and objectives including Quality and Safety Goals.Collaborates with key stakeholders, peers and other departments to facilitate and monitor the timely completion of agreed upon corrective action plans arising from survey findings, root cause analyses or other sources.Plans, coordinates and reports on a Failure Mode Effect Analysis.Facilitate and participate in MSHS improvement initiatives as appropriate.Supports an information system for quality and regulatory management data collection, data aggregation, and data analysis as well as the maintenance of an inventory of quality improvement activities including safety solution measures of success.Monitors and displays statistical data for quality reports and evaluations.Serves as internal resources for the quality and performance improvement process including data measurement, tool development, chart review, improvement strategies and education on improvement methodologies. Serve as a liaison with regulatory data abstraction and reporting.Uses knowledge of standards of accreditation and regulatory agencies to assist with assessment of compliance. Conduct ongoing tracer rounds including observation, interview and medical record review to engage staff and assess compliance.Participates in the preparation, planning, coordination and oversight of planned and unplanned regulatory survey and reporting by The Joint Commission, New York State Department of Health, CMS and other regulatory agencies as required.Participates in the preparation, planning, coordination and oversight of disease specific certifications.Develops and facilitates education workshops, meetings or conferences focused on improvement methodologies and regulatory compliance with high impact on program and/or participants; coordinates logistics, scheduling and participant communications.Develops and writes communications and promotional literature for distribution such as newsletters, brochures or flyers; coordinates process from development through printing and distribution for quality and regulatory purposes.Participates as a member of the hospital Quality Performance and Improvement Committee.Supports and maintains the quality structure, which includes all quality related committees including preparation of documentation and flow of material.Supports the hospital Quality Performance and Improvement Committee, designated departmental committees, performance improvement taskforces and organizational improvement teams as appropriate.Investigates and coordinates responses to quality of care inquiries arising from IPRO and other third party sources and patient complaints/grievances.Interacts and maintains liaison with students, faculty, staff and outside/community agencies or committees in facilitating program objectives.Maintains effective communication and working relationships with a wide variety of staff (hospital, medical, ambulatory, behavioral) to support and facilitate quality -related initiatives.Requirements:Master's degree required (MPH, MPA, MBA, MA, MS, MSN)Prior healthcare industry experience preferred, especially in the areas of quality or regulatory management, project management, and/or change management.CPHQ, Lean Six Sigma preferredStrength Through DiversityThe Mount Sinai Health System believes that diversity, equity and inclusion are drivers for excellence. We share a common devotion to delivering exceptional patient care. Yet we're as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai's unrivaled record of achievement, education, and advancement as we revolutionize medicine together and participate actively as a leader within the Mount Sinai Health System by:Serving as the primary resource management representative of the Mount Sinai leadership teams, committees, etc., and acting as the primary executive leader interface between Mount Sinai and key executives from the health systems' vendors and partnersEngaging with relevant thought leaders and policy-makers at the federal and state levels, and representing the Health System as assigned.Using a lens of equity in establishing and promoting policies and procedures and providing opportunities for all to thrive.Confronting racist, sexist or other inappropriate behavior and challenges exclusionary organizational practices and serving as a role model to promote anti-racist behaviors.Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers.We work hard to acquire and retain the best people, and to create a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care. Explore more about this opportunity and how you can help us write a new chapter in our story! Who We AreOver 42,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai Morningside (formerly Mount Sinai St. Luke's), and New York Eye and Ear Infirmary of Mount Sinai.The Mount Sinai Health System (MSHS) provides equal employment opportunity to all its employees and applicants for employment without unlawful discrimination on the basis of their actual or perceived race, creed, color, religion, national origin, sex, gender, gender expression, gender identity, age, disability, marital or parental status, sexual orientation, veteran, immigration, citizenship, or other protected status.EOE including Veterans and DisabledCompensationThe Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for this role is $87692 - $131538 ANNUAL. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

Created: 2025-05-09