BWH QI Coordinator

Description

Position Summary:

The Quality Improvement (QI) Coordinator supports organization-wide performance and quality initiatives across inpatient and outpatient behavioral health programs. This role works collaboratively with the Chief Nursing Officer, Director of Facility Operations, CEO, and other department leaders to coordinate data-driven quality assurance activities, regulatory compliance functions, and survey preparedness. They report to the Compliance Manager. The QI Coordinator ensures timely reporting, effective data management, and ongoing support of safety, performance, and accreditation efforts.

Essential Job Functions:

• Coordinate Quality Improvement Committee (QIC) activities, including data collection, agenda preparation, and minutes.
• Track and analyze clinical quality data, patient satisfaction surveys, and incident reports to identify trends and support action planning.
• Maintain documentation for accreditation readiness (Joint Commission, CMS, BSAS, DMH), including Measures of Success, FMEAs, and audit tools.
• Assist departments in preparing QI reports, dashboards, and benchmarking data.
• Monitor and manage QNet, Press Ganey access, ORYX, and internal safety surveys.
• Organize and support Safety/EOC and Pharmacy & Therapeutics (P&T) Committees, including meeting logistics and action tracking.
• Maintain building maintenance inspection records, recall notifications, and safety data sheets in coordination with the Director of Facility Operations.
• Provide administrative backup for the Executive Office as needed.
• Manages and maintains affiliation agreement records.
• Support new staff training on QI-related procedures and tools.
• May Assist with Human Rights complaints and tracking
• Complete special projects as assigned by leadership.
  
  

Qualifications

Education & Experience:

• Associate’s or Bachelor's degree in healthcare administration, public health, or a related field preferred.
• Minimum of 1 year experience in healthcare quality, regulatory, or administrative roles.
• Knowledge of Joint Commission, CMS, and behavioral health regulatory standards preferred.
• Proficient in Microsoft 365, Excel, Word, and data management applications.
• Strong organizational, communication, and problem-solving skills.
• High attention to detail, ability to prioritize tasks, and maintain confidentiality.
  
  

Bournewood is a drug-free workplace. All Bournewood employees agree not to use any federally illegal substances including but not limited to marijuana and related products. Following an offer of employment and prior to reporting to work, all applicants will be required to submit to and pass a drug test.