Director of Quality, Informatics, Employee Health, & Education in Muleshoe, Texas at Muleshoe Area Hospital District

Job Title:

Director of Quality, Informatics, Employee Health & Education

Department:

Quality & Clinical Operations

Reports To:

Chief Executive Officer (CEO) and/or Chief Nursing Officer (CNO)

Position Summary

The Director of Quality, Informatics, Employee Health & Education is a senior clinical and operational leader responsible for overseeing quality improvement, patient safety, regulatory compliance, clinical informatics, employee health services, and staff education across both the Hospital and Nursing Home. This role ensures high-quality, safe, and compliant care delivery through data-driven decision-making, workforce development, and continuous performance improvement, while supporting organizational strategic goals.

This position plays a critical role in ensuring safe, compliant, and high-quality care across the Hospital and Nursing Home. By integrating quality leadership, informatics, employee health, and education, the Director supports clinical excellence, regulatory success, and workforce competency while advancing the organization’s mission and strategic priorities.

Qualifications:

Education

Required: Bachelor of Science in Nursing (BSN) or related healthcare field.

Preferred: Master’s degree in Nursing, Healthcare Administration, Public Health, Quality, or Informatics.

Licensure & Certifications

Current, unrestricted Registered Nurse (RN) license (if nursing background).

Quality, patient safety, informatics, or nurse executive certification preferred (e.g., CPHQ, NE-BC, RN-BC).

Experience

Minimum of 5 years progressive leadership experience in healthcare.

Demonstrated experience in:

Quality improvement and regulatory compliance.

Hospital and/or long-term care operations.

Clinical informatics or EHR optimization.

Staff education and competency management.

Experience working with CMS surveys and accreditation processes preferred.

Key Responsibilities:

1.Quality, Patient Safety & Performance Improvement

Lead organization-wide quality assurance and performance improvement (QAPI) initiatives for the Hospital.

Monitor, analyze, and report quality metrics, patient safety indicators, infection prevention data, and clinical outcomes.

Develop, implement, and evaluate corrective action plans based on data trends, audits, and regulatory findings.

Oversee root cause analyses (RCA), failure mode and effects analyses (FMEA), and other risk management activities.

Ensure alignment with CMS Conditions of Participation, CIHQ, state, and federal regulations.

Serve as the primary leader for survey readiness, accreditation activities, and external audits.

2.Clinical Informatics & Data Management

Oversee clinical informatics strategy, including EHR optimization, data integrity, and clinical documentation standards.

Partner with IT, clinical leaders, and vendors to improve workflows, reporting, and clinical decision support.

Develop dashboards and reports to support quality, compliance, staffing, and operational decision-making.

Ensure accurate data submission to regulatory bodies and quality reporting programs (e.g., CMS, NHSN, MDS, QAPI).

3.Employee Health & Occupational Safety

Direct employee health programs for both inpatient and long-term care settings.

Ensure compliance with OSHA, CDC, CMS, and state requirements related to employee health and workplace safety.

Oversee immunization programs, exposure tracking, infection control collaboration, and return-to-work protocols.

Promote staff wellness initiatives and support a culture of safety.

4.Education, Training & Workforce Development

Lead development, coordination, and evaluation of clinical education and competency programs for nursing and clinical staff.

Ensure orientation, annual competencies, mandatory education, and skills validations meet regulatory and organizational standards.

Support leadership development, clinical ladder initiatives, and continuing education efforts.

Collaborate with department leaders to address performance gaps through targeted education.

5.Leadership, Collaboration & Strategic Support

Serve as a clinical and operational resource to executive leadership, department directors, and medical staff.

Act as a liaison between quality, nursing, medical staff, IT, and ancillary departments.

Participate in strategic planning, policy development, and organizational committees.

Promote a culture of accountability, transparency, continuous improvement, and evidence-based practice.

Knowledge, Skills & Abilities

Strong leadership, analytical, and organizational skills.

Advanced knowledge of healthcare regulations, quality standards, and patient safety principles.

Ability to interpret complex clinical and operational data.

Excellent communication and collaboration skills.

Ability to lead change initiatives across multiple care settings.

High level of integrity, accountability, and professionalism.

Physical & Environmental Requirements.

Office and clinical environment.

Ability to attend meetings, surveys, and staff education sessions across hospital and nursing home settings.

May include occasional after-hours or on-call responsibilities during surveys or critical events.