Medical Governance Consultant

Requirements

• Education - bachelor's degree in medicine, nursing, healthcare management, or a related field. Advanced degree (e.g., master's in healthcare administration, Public Health) or certification in clinical governance, quality management, or healthcare compliance is preferred.
• Experience - Minimum of 8-10 years of experience in a healthcare governance, clinical leadership, or quality assurance role. Proven experience in policy development, complaint resolution, and managing clinical documentation.
• Technical / functional skills: Strong leadership, communication, and problem-solving skills. Deep understanding of healthcare regulations, quality assurance practices, and clinical governance frameworks.
• Business skills: In-depth knowledge of local and international healthcare standards, including ISO certification and accreditation processes.

Benefits

Additional Information

MediCard Phils., Inc. is one of the country's leading HMO and the only HMO founded and run by Doctors. Since its inception, the concept of service-oriented total health care has been the molding ideal of MediCard. The competition is vast, and the benefits being offered by the competitors are tempting. However, MEDICard has taken the lead in providing innovative and productive ideas that cut down the cost of health maintenance without compromising its quality. MediCard now boasts of more than half a million members and over 54,000 accredited doctors in over 1,000 hospitals and clinics nationwide. It also operates 16 MediCard free-standing clinics that provide services at par with those offered by hospitals minus the confinement. MediCard is currently looking for assertive, dynamic and energetic individuals to fill up the following vacancy: The role is primarily office-based but may require frequent travel to various clinic locations. The Medical Governance Lead will also work closely with corporate clients and attend meetings with senior management. DUTIES & RESPONSIBILITIES 1. Strategic Leadership & Management (Overall): - Develop and implement the organization's medical governance and quality management strategy, aligning with organizational goals and regulatory requirements. - Provide leadership, guidance, and mentorship to the Medical Governance & Quality Management Associates. - Foster a culture of quality, safety, and continuous improvement throughout the medical division. - Monitor industry best practices and emerging trends in healthcare quality management. 2. Clinical Governance Compliance - Oversee the implementation and monitoring of clinical policies, ensuring effective communication and training. - Lead and manage clinical audit programs, including planning, execution, and reporting. - Drive patient safety initiatives, including incident investigations, root cause analysis, and development of safety protocols. - Collaborate with clinical leaders to address quality and safety concerns. 3. Statutory & Regulatory Compliance - Ensure the organization's compliance with all applicable laws, regulations, and guidelines from governing bodies (DOH, PhilHealth, PRC, LGU). - Oversee the development and submission of accurate and timely compliance reports. - Manage the organization's licensing and accreditation processes, ensuring all requirements are met. - Serve as the primary point of contact for regulatory inquiries and audits. 4. ISO 9001:2015 Compliance - Lead the development, implementation, and maintenance of the organization's Quality Management System (QMS) in accordance with ISO 9001:2015 5. Complaints Handling - Oversee the complaint management process, ensuring timely and thorough investigations. - Analyze complaint data to identify trends and systemic issues, and implement corrective actions. - Develop and implement strategies to improve complaint resolution and prevent recurrence. - Ensure that proper documentation is maintained for all complaint cases. 6. Customer Feedback & Patient Experience Management - Develop and implement strategies for collecting and analyzing patient feedback through various channels. - Prepare and present reports on patient satisfaction and feedback trends to management. - Lead quality improvement initiatives based on patient feedback and data analysis. - Ensure that feedback collection tools are effective.

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