Facilitates quality improvement and improvement risk management efforts by: assisting with the development of corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials, member satisfaction surveys, and auditing surveys; ensuring process improvements are compliant with established internal and external regulation requirements at the local level; conducting root cause analysis, failure mode and effect analysis, and other assessments in response to significant events, near misses, and good catches in order to identify areas of improvement; and exercising independent judgment to escalate high-risk issues and trends to appropriate entity for resolutions. Serves as the subject matter expert for quality improvement processes and regulations within assigned departments by: learning current internal policies and external regulations; participating on committees, projects to propose a course of action on the enforcement, development of policies or procedures of regulations and auditing processes; fostering collaborative, results oriented partnerships to ensure compliance with regulations and improve patient safety, maintain the KP safety culture, reporting accuracy, and health outcomes; delivering educational programs to raise awareness for regulation requirement, internal concerns, and system/database usage; and anticipating issues, weigh practical considerations in addressing issues and seek input from engagement manager/sponsor to resolve.