ABOUT NYC HEALTH + HOSPITALS

Lincoln Medical and Mental Health Center is one of New York City’s premier acute care hospitals. Located in Downtown Bronx, Lincoln is a teaching hospital renowned for its Centers of Excellence, and a recognized industry leader in the implementation of state-of-the art medical technology and best practices. Our team of highly trained and caring medical professionals is dedicated to providing the highest quality health care that is safe, compassionate, culturally competent and patient-centered. Comprehensive services are offered in three major primary care areas: Medicine, Pediatrics, and Women’s Health in addition to more than eighty (80) specialty services. At Lincoln, the safety and comfort of our patients is our number one priority.
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

MINIMUM QUALIFICATIONS

1. A Master’s degree from an accredited college or university in biological or chemical sciences, clinical/medical
   laboratory sciences/technology, hospital administration, health care planning, business administration or an
   approved related program, and four (4) years of progressively responsible laboratory or blood bank quality,
   laboratory research, or laboratory testing experience; or
2. A Bachelor’s degree in one of the disciplines listed in “1” above, and six (6) years of experience, as described
   in “1” above.

Purpose of Position:
Under direction of the Laboratory Medical Director, and in collaboration with other laboratory, operational, and technical leaders, provides oversight and support for laboratory quality assurance initiatives, and manages process improvement activities across laboratory teams and departments. Promotes compliance with laboratory quality standards by ensuring adequate monitoring, communication, training, competency assessment, and, as needed, remedial and preventative measures.
Essential Duties and Responsibilities:
1. Develops and maintains the hospital’s laboratory Quality Management System (QMS) and related programs, in adherence with internal and external regulatory and accreditation guidelines and requirements.
2. Leads and provides strategic advice and guidance related to laboratory quality and process improvement efforts involving various departments.
3. Drives laboratory-related process improvement projects for the health care setting by serving as the laboratory quality lead and partnering with local quality and safety leadership teams.
4. Serves as a quality and regulatory subject matter expert and a document review and compliance assessment resource for the laboratory.
5. Implements and maintains an effective quality management system using integrated systematic approach to quality throughout the entire laboratory.
6. Establishes departmental quality improvement monitors based on regulatory requirements, on-going laboratory data analysis, and feedback.
7. Monitors, investigates and ensures proper follow-up to laboratory related complaints and non-conformances.
8. Participates in patient safety committees and related activities.
9. Performs and oversees scheduled and non-scheduled internal audits of entire department, including corrective action for all deficiencies identified.
10. Interacts and coordinates activities with all stakeholders as part of ongoing monitoring of compliance with all requirements of the laboratory’s Quality Management System (QMS) and related programs.
11. Responsible for documenting, reviewing, and evaluating internal and external quality related complaints for presentation to appropriate committees.
12. Performs root cause analyses, implements corrective and preventive action plans, and monitors sustained compliance with implemented changes.
13. Ensures compliance with New York State Department of Health (NYSDOH), College of American Pathologists (CAP), Clinical Laboratory Improvement Amendments (CLIA), International Organization for Standardization (ISO) 15189, and other regulatory and accreditation requirements.
14. Performs other related quality duties, as required.