Transplant Quality Manager

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor's degree in Health Care Administration, Public Health, Quality, or a related field.

2. Six Sigma Certification

EXPERIENCE:

1. Two (2) years of experience in healthcare quality, regulatory compliance, transplant services, or a closely related area.

PREFERREDQUALIFICATIONS:

EXPERIENCE:

1. Experience in transplant services or highly regulated specialty programs.

2. Familiarity with transplant regulatory bodies and performance reporting requirements

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

Regulatory Compliance & Survey Readiness

1. Overseas ongoing compliance with transplant regulatory and accrediting requirements, including CMS, HRSA, OPTN/UNOS, and SRTR standards.

2. Maintains continuous survey readiness and coordinates preparation for regulatory surveys, audits, and site visits.

3. Leads development, review, and maintenance of transplant-required policies, procedures, and documentation to ensure alignment with current regulations and guidance.

4. Tracks regulatory updates and proactively implements required changes across transplant programs.

Quality Monitoring & Performance Improvement

5. Develops, monitors, and reports transplant-specific quality metrics, outcomes, and performance indicators.

6. Analyzes outcome trends, identifies risk areas, and partners with leadership to develop and implement performance improvement initiatives.

7. Supports corrective action plans, performance improvement plans, and ongoing monitoring when performance concerns are identified.

8. Ensures alignment of transplant quality initiatives with organizational quality and patient safety goals.

Data Oversight & Reporting

9. Collaborates with data coordinators, clinical teams, and leadership to ensure timely, accurate, and complete submission of required transplant data.

10. Supports validation and integrity of transplant data used for internal review, regulatory reporting, and public outcomes reporting.

11. Prepares and presents quality and performance reports for transplant leadership, committees, and governing bodies.

Collaboration & Education

12. Serves as a subject matter expert for transplant quality and regulatory requirements.

13. Provides education and guidance to transplant staff and leadership regarding quality standards, regulatory expectations, and best practices.

14. Participate in transplant committees, quality meetings, and interdisciplinary workgroups to support quality and compliance efforts.

Program Development & Strategic Support

15. Supports new transplant program development, program expansion, and growth initiatives by ensuring quality and regulatory requirements are met from planning through implementation.

16. Assists leadership with risk assessment, readiness planning, and strategic decision-making related to transplant quality and compliance.

PHYSICAL REQUIREMENTS: 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.

1. Requires full range of body motion, manual finger dexterity,handand eye coordination.

2. Requires working under stressful conditions

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Desk work (phone calls, computer, completing paperwork,etc)

SKILLS AND ABILITIES:

1. Strong interpersonal and communication skills.

2. Proficient computer/keyboard skills

3. Ability to work independently, handle multiples tasks, set appropriate priorities and accomplish assignments in a thorough and timely manner.

4. Demonstrates critical thinking skills

5. Ability to work independently

Additional Job Description:

Scheduled Weekly Hours:

Shift:

Exempt/Non-Exempt:

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Cost Center: