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Accreditation & PM/QI Coordinator

Weber County
Ogden, UT
  • Posted: over a month ago
  • Full-Time
Job Description


Under general supervision from the Director of Health, acts as accreditation coordinator to ensure success of accreditation efforts and maintains certification. Leads and manages the accreditation process; interprets PHAB standards and measures, and collaborates with the leadership team to assure standards and measures are met. Works with regulatory and accreditation agencies to ensure compliance with all applicable standards. Develop, implement, and coordinate efforts to ensure that performance management (PM) and quality improvement (QI) processes, policies and procedures are adopted throughout the department.


(Any one position may not include all of the duties listed, nor do the listed examples include all duties which may be found in positions of this class.)

Manages and coordinates committees and project teams. Coordinates and/or provides PM/QI education and training to department staff. Researches and develops appropriate PM/QI trainings that enable workforce improvements.

Develops, co-chairs, and maintains a department-wide PM/QI management committee with representation from each division. Convenes regularly scheduled meetings, determines agendas; develops and analyzes performance improvement data for the committee; develops and implements a department-wide PM/QI communication plan; develops and implements a recognition program. Assists in the development and maintenance of PM/QI plans, policies and procedures.

Designs and develops performance studies and quality improvement evaluation criteria. Implements a PM/QI process that leads to a positive and measurable impact on the department and public health programs. Evaluates the PM/QI program; initiates and implements changes as needed or as directed.

Establishes a continuous PM/QI monitoring and reporting system. Ensures necessary data is collected on a timely basis; prepares, distributes, and presents reports on PM/QI efforts, status, and impacts; creates reporting documents to use for tracking quality improvement activities, trends, and patterns, and identifying opportunities for improvement. Coordinates and prepares an annual PM/QI report.

Researches and identifies best PM/QI practices; reports findings to department administrators, and prepares and makes recommendations on adopting and implementing new PM/QI practices.

Provides support to each division by identifying and recommending areas for improvement; implements recommended PM/QI practices to advance department/division improvements; participates in organizational strategic planning, and provides leadership and coordination for improving the department's core public health functions.

Coordinates with State Health Department's performance and quality initiatives to ensure alignment and optimal use of resources. Performs other related duties as assigned.


Education: Graduation from an accredited college or university with a Master's Degree in public health, health services administration, healthcare administration, nursing, public or business administration, or a closely related field, plus three (3) years of paid full-time employment in public health, related PM/QI processes, or health administration.

Preference for experience performing related PM/QI duties.


Graduation from an accredited college or university with a Bachelor's Degree in public health, healthcare administration, nursing, or a closely related filed, plus four (4) years of paid full-time employment in public health, related PM/QI processes, or health administration, nursing, environmental health, or a directly related field. An acceptable combination of education and experience may be considered. Preference for experience performing related PM/QI duties.

Experience: Three years of increasingly responsible experience in clerical work. Work experience must be appropriate to the position to be filled.

OR Any equivalent combination of education and experience.

Knowledge: public health functions, structures, and resources; essential public health services; public health organizations and programs; principles and practices of performance management and quality improvement; PHAB standards and measures; group training; facilitating group processes; preparing analysis, including interpreting statistics and evaluating research studies; preparing comprehensive reports related to public health issues; planning, designing and evaluating public health program initiatives. Working knowledge of: departmental practices, policies and procedures, standard office computer operations and software applications including word processing, data entry, spreadsheets, and presentation programs.

Skills: customer relations; operating all applicable computer hardware and software programs/applications; operating standard office equipment including a multi-line telephone, and multi-function printer/copier/fax machine. This position may require the driving of a motor vehicle; skill in operating a motor vehicle in a safe manner; knowledge of Utah motor vehicle rules and regulations.

Abilities: apply PM and QI tools, practices, and principles to public health; organize projects; conduct group facilitation; prepare and present informative, concise and accurate reports; read, interpret, analyze and organize statistical data; read, interpret and write reports; work for sustained periods of time maintaining concentrated attention to detail; make sound decisions on public health issues; perform duties with minimal supervision; prepare and deliver effective presentations to large groups; write policies and procedures; graphically represent data; operate all applicable computer hardware and software; communicate effectively (verbally and in writing); follow written and oral instructions; establish and maintain effective and productive working relationships with supervisors, other employees, public health agencies, and the general public.


Must have a Utah Driver's License and a good driving record. Must be adaptable to changing work hours depending on scheduled events. Must be willing to work evening, Saturdays, Sundays and holidays. Must have a cell phone which can be used for communication with other staff as needed.


The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The employee must frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.


The noise level in the work environment is usually quiet.

Job Posted by ApplicantPro

Weber County


Ogden, UT
84401 USA



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