Clinical Quality Improvement Coord

York, PA | Professional | Tracking Code: 65658

Job Description:

Under the general supervision of the Director-Quality, Regulatory Compliance & Patient Safety (WSRH), supports and coordinates Hospital-wide education and performance improvement activities. Through consultative, educational and direct support, advises and assists Administration, Medical Staff and department directors in the areas of performance improvement. Works closely with the physician and clinical staffs of the Hospital to analyze and improve clinical care practices. Promotes and maintains a Hospital-wide environment of safe care for patients treated at the Hospital. Collaborates with appropriate organizational leaders in coordination with appropriate accreditation agency(s) and Department of Health survey preparation at the Hospital.


Duties and Responsibilities


  1. Identifies and uses, as appropriate, internal and external resources to assist with the development of training and educational programs.
  2. Provides educational sessions for WellSpan Surgery and Rehabilitation Hospital staff as identified from an educational assessment and other avenues.
  3. Routinely meets with Managers to identify staff or department educational needs.
  4. Assists in the development and implementation of clinical competencies.
  5. Uses various databases to compile, track, analyze and report data and prepares regularly scheduled or special reports.
  6. Oversees the Medical Staff Peer Review process, including case identification, documentation and reporting.
  7. Collaborates with the Director to ensure ongoing coordination and compliance with appropriate accreditation standards and Department of Health regulations. Keeps abreast of appropriate regulatory agency requirements and communicates changes to the appropriate WellSpan entity.
  8. Manages clinical PI projects by communicating quality indicators to stakeholders and management; tracking quality and patient safety issues; facilitating team process and collaboration; coordinating data collection/analysis; supporting testing/ implementation tools; and reporting of variances. Supports CETs, IHI and system initiatives.




  • Notes:
    • Other combinations of formal education, training and experience may be considered.


  • Minimum Experience:
    • 3 - 5 years in acute care setting. Experience in rehabilitation preferred


  • Minimum Education:
    • Bachelor's Degree


  • Required Certification:
    • Registration and current RN license in PA; CPR certification


  • Skills:
    • Knowledge of theory and process of performance improvement, facilitation, project management and data analysis skills a plus; Excellent communicator with problem solving skills; must be flexible and able to function under pressure; organizational skills, independent thinking and management competencies
    • :Knowledge of regulatory standards, both national and state, an advantage. Demonstrated experience in preparing for and handling state and federal surveys would be an advantage
James Kane
James Kane
Sr. Talent Acquisition Consultant
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Why WellSpan Health?

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization comprises a multispecialty medical group of more than 1,600 physicians and advanced practice providers, a regional behavioral health organization, a home care organization, eight respected hospitals, more than 20,000 employees and 200 patient care locations. WellSpan is a charitable, mission-driven organization committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Employment Benefits

  • Sign-on incentives for new employees (click here for details)
  • Medical, dental and vision insurance
  • Life and accidental death insurance
  • Supplemental life insurance
  • Retirement savings plan
  • Paid time off (PTO)
  • PTO bridging
  • Short-term disability
  • Educational assistance
  • Forgivable loan
  • Flexible spending
  • Credit union
  • Employee recreational activities
  • Childcare
  • Complimentary medicine discounts

Diversity & Inclusion

Welcome. Respect. Value.

Wellspan Health believes that diversity includes all the human characteristics that make each of us similar as well as different. We strive to make every person feel welcomed, respected, and valued while creating a safe and inclusive environment where we all have the individual freedom to express our uniqueness in a respectful manner.

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more — within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)