Laboratory Quality Analyst

GENERAL SUMMARY:

Responsible for conducting complex analysis of laboratory data for integrity, trends and improvement opportunities which support effective and efficient delivery of care and achievement of strategic, clinical and operational goals. Leverages laboratory knowledge of processes, workflows and evidence-based practice to report information in a meaningful and understandable way. Involved in the design, development, testing, integration, implementation, training and support of the laboratory Quality Management System (QMS).

PRINCIPAL JOB FUNCTIONS:

1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.

2. *Retrieves and assembles data from a variety of databases to support quality improvement initiatives, compliance with regulations/standards for management oversight and laboratory related organizational goals.

3. *Conducts thorough data analysis including statistical analysis; evaluates findings in comparison to current and past trends; benchmarks data from other laboratories and standardized information from other sources; develops and analyzes data utilizing programs and tools to facilitate data-driven organizational decisions and achieve quality goals; interprets visual and summarized data findings.

4. *Ensures data integrity by following data governance principles (e.g. data stewardship, data quality, metadata management, data privacy); ensures that data is entered into respective databases; establishes data definitions and performs data validation by verifying accuracy and completeness of data; collaborates with the organization's data analytics department.

5. *Designs clear, informative and engaging visualizations that accurately and efficiently represent process and outcomes metrics.

6. *Serves as a subject matter expert in regulatory and accreditation requirements (e.g. College of American Pathologist (CAP), Clinical Laboratory Improvement (CLIA), and Association for the Advancement of Blood & Biotherapies (AABB)) and laboratory standards (e.g., Clinical Laboratory Standards Institute (CLSI)).

7. Collaborates with the organization's information technology department and operational departments to ensure that regulatory requirements are completed on an ongoing basis (e.g. data submission, attestation, and laboratory report build, testing, and verification); primarily responsible for scheduling test report validations in accordance with regulatory requirements (e.g. CAP).

8. *Consults with laboratory leadership and medical center staff in defining and describing appropriate requests for clinical data; designs, produces and distributes clinical data reports; researches and analyzes external data to assist in laboratory improvement efforts; provides consultation regarding data management.

9. Collaborates with laboratory specialists and health system laboratory management to develop, update, and maintain policies and procedures to meet CAP, CLIA, and AABB regulations and CLSI standards.

10. *Prepares agenda and leads the health system Laboratory Quality Council meetings and initiatives.

11. * Maintains schedule and facilitation of quality compliance activities and tasks (e.g., pipette and scale calibrations, Biosafety Cabinet (BSC) service, tachometer calibrations).

12. *Prepares, organizes, and coordinates internal and external inspections, including supportive documentation.

13. Supports, facilitates and actively participates in the organization's quality improvement initiatives by collaborating with multi-disciplinary teams to design appropriate measurement systems.

14. *Proactively monitors in-scope software for functional and/or system errors (e.g., temperature monitoring system), utilizes vendor support services, coworkers and other resources for analysis, problem solving and restoration of the system; documents steps taken by user to locate the source of the problem; follows up with appropriate personnel to correct errors.

15. Develops and maintains manual and computerized variance/incident and feedback reporting systems that allow for the timely collection of data necessary to guide program and plan modification and conduct investigations, including root cause analysis.

16. Converts user requests of modifications to software applications and interfaces into functional specifications; develops implementation timeframe with departmental personnel and other affected areas; installs and tests programs; assists with the development of advance communication regarding scheduled implementation; monitors and evaluates program performance after implementation.

17. *Collaborates with IT and third-party organizations to develop, validate and maintain data transfer interfaces for regulatory, accreditation, or contracted quality data report and internal system connections.

18. Retrieves/abstracts data for regulatory and voluntary reporting, as well as assessing competency and improvement.

19. Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

20. Participates in meetings, committees and department projects as assigned.

21. Performs other related projects and duties as assigned.

(Essential Job functions are marked with an asterisk "*". Refer to the Job Description Guide for the definition of essential and non-essential job functions.) Attach Addendum for positions with slightly different roles or work-specific differences as needed.

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

1. Knowledge of disease process to include basic anatomy and physiology.

2. Knowledge of laboratory, medical, and pharmacological terminology.

3. Knowledge of data management, statistical analysis and informatics.

4. Knowledge of hospital systems including the design and function of hospital medical records.

5. Knowledge of coding principles and appropriate coding for reimbursement.

6. Knowledge of quality improvement principles and methods.

7. Knowledge of computer hardware equipment and software applications relevant to work functions.

8. Advanced skill in analyzing problems, identifying needs and priorities and implementing effective solutions.

9. Ability to analyze integrity of data.

10. Ability to communicate effectively, both verbally and in writing and manage complex projects.

11. Ability to prioritize work demands and work with minimal supervision.

12. Ability to maintain confidentiality relative to sensitive information.

13. Ability to work as a team member with multi-disciplinary teams as leader or participant.

14. Ability to establish and maintain effective working relationships with all levels of personnel, medical staff, volunteer, ancillary departments and vendors.

15. Ability to provide leadership, coaching and mentoring to colleagues.

16. Ability to maintain regular and punctual attendance.

EDUCATION AND EXPERIENCE:

Graduate from an accredited clinical or technical program in Allied Health required. Bachelor's degree in a chemical, physical, or biological science from an accredited institution required. Minimum of two (2) years clinical laboratory experience in high complexity testing preferred. Prior training and experience in quality assurance or quality management systems preferred.

OTHER CREDENTIALS / CERTIFICATIONS:

Medical Laboratory Scientist certification from the American Society for Clinical Pathology (MLS(ASCP)CM) or equivalency preferred. Additional certifications in Lean, Six Sigma, or CPHQ preferred.

PHYSICAL REQUIREMENTS:

(Physical Requirements are based on federal criteria and assigned by Human Resources upon review of the Principal Job Functions.)

(DOT) - Characterized as sedentary work requiring exertion up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body. Involves sitting most of the time, but may involve walking or standing for brief periods of time.