Management and Program Analyst

Develop processes to assess and validate compliance checklists applicable to The Joint Commission standards.

Analyze and provide accreditation compliance reports, executive summaries, and briefings to the executive staff.

Develop and implement the execution of facility-wide mock surveys and analyze the results to identify and mandate correction of vulnerabilities.

Manage the organization’s preparation and report of significant findings related to patient care practices to the Quality Council, Medical Executive Committee (MSEC) and Executive Committee.

Provide critical support to the Chief Medical Officer to ensure the organization is operated in strict compliance with the Defense Health Agency regulations.

Ensure data is relevant and meets regulatory requirements for The Joint Commission and DoD compliance with Quality Improvement/Process Improvement program(s).

Advise department chiefs and other staff on findings of analysis and recommends methods for improving outcomes.

Serve as the Military Treatment Facility's senior technical expert for the Performance Improvement (PI) program.

Develop policies and governance to standardize Performance Improvement (PI) procedures and training across the command.

Facilitate performance improvement activities throughout the organization that includes the planning, developing, directing, organizing and evaluating of improvement initiatives and ongoing measures of organization performance.

Collaborate with Patient Safety Manager, Risk Manager, Safety Manager, Clinical Operations, Patient Experience/Satisfaction, and Department Chiefs through the strategic planning process to prioritize quality assessment and performance improvement.

Who May Apply: US Citizens In order to qualify, you must meet the experience requirements described below.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience.

Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.

Specialized Experience: One year of specialized experience which includes 1) supporting hospital readiness and accreditation programs in alignment with The Joint Commission standards; 2) collaborating with hospital leadership and clinical staff to identify operational deficiencies and recommend process improvements; 3) interpreting and applying regulatory guidance to ensure compliance with healthcare regulations; and 4) retrieving, analyzing, and interpreting data from electronic health systems to identify trends.

This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-11). supporting hospital readiness and accreditation programs in alignment with The Joint Commission standards; collaborating with hospital leadership and clinical staff to identify operational deficiencies and recommend process improvements; interpreting and applying regulatory guidance to ensure compliance with healthcare regulations; and retrieving, analyzing, and interpreting data from electronic health systems to identify trends. **Some federal jobs allow you to substitute your education for the required experience in order to qualify.

For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted.