Ohood A Swailem
Riyadh
Summary
Accomplished Senior Specialist with extensive experience in quality management, healthcare systems, and strategic planning. Proven track record in leading and organizing high-impact national initiatives within the healthcare sector. Adept at developing and implementing quality improvement strategies, managing risk, and ensuring compliance with healthcare standards. Recognized for strong leadership, strategic thinking, and dedication to organizational excellence. Holds a Master of Public Health in Health System and Quality Management and multiple certifications in governance, performance, quality management and organizational excellence.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Quality Systems Senior Specialist
Centre for National Health Insurance
Riyadh
02.2021 - Current
- Establish the risk register for the Clinical department towards the activation plan and delivering the yearly milestones
- Develop the Clinical Review and Investigation Section strategy to facilitate the clinical audit of purchasing services from Private Network Providers aligned with Overspill strategy to ensure effective purchasing of services
- Develop a dashboard for the Clinical Review and Investigation Section KPI’s and OKR’s to have a robust data base to track achievements and improve the process
- Initiate legal targets for health benefits package, population health management and their quality KPIs to be part of the payment model contracts with Health Clusters
- Led the deployment of the National Efficiency Collaborative with Public and Private Network Providers
- Led 100-day project as per MoH Minister to transfer Long Term Care patients from Private Providers to Home Health Care Public Providers
Associate Project Manager
Vision Realization Office, MoH
Riyadh
11.2018 - 02.2021
- Set up the clinical leadership division by strategic planning, forecasting FTE's and create operational
- Plan for yearly initiative aligned with the strategic objectives and VRO vision
- Led the National Implementation of Value-Based Healthcare through Prototyping of the International Consortium of Health Outcomes Measurements (ICHOM) and Patient Reported Outcomes Measure
Quality Billing Specialist
King Faisal Specialist Hospital & Research Centre
Riyadh
07.2017 - 11.2018
- Provide recommendations of billing audits results to the CEO in the Revenue Cycle Management Committee
- Review the CPT and ACHI codes of services in the Venus system to export the high-cost services and apply Pareto chart tool
- Yearly strategic planning of the billing audits as per the 4 Cs tool to support the readiness of the organizational efficiencies toward healthcare transformation
Acting Quality Data Manager
King Faisal Specialist Hospital and Research Centre
Riyadh
02.2016 - 07.2017
- Manage survey results of Patient Satisfaction, Employee Satisfaction, and other survey requests
- Analyze the survey data and liaise the identified challenges on organizational level
- Led organizational level performance data, departmental quality scorecards, and corporate dashboard
Quality Analyst
King Faisal Specialist Hospital & Research Centre
Riyadh
02.2014 - 02.2016
- Initiate, measure, and report key performance indicators for allied health and managerial (Supply Chain, Finance and Architecture) departments on corporate level
- Coordinate the Evidence Based Practice Committee activities to initiate and review clinical pathways and guidelines
- Conduct training for implementing new Clinical Pathways
- Present the clinical pathways reports progress to the departments Chiefs including areas for improvement
- Collect clinical pathways data, perform data validation, analyze and build reports across all hospital departments
Staff Registered Nurse
King Faisal Specialist Hospital & Research Centre
Riyadh
04.2011 - 02.2014
- Monitoring post-operative patients' levels of recovery and consciousness from anesthesia and provide treatment
- Effective pain management for post-operative patients
Education
Master of Science - Public Health, Health System & Quality Management
King Saud Bin Abdulaziz For Health University
Riyadh, KSA01.2017
Bachelor of Science - General Nursing
King Saud University
Riyadh, KSA01.2010
Skills
- Leadership
- Empowerment
- Self-development
- Dedication
- Networking
- Strategic Thinker
- Enterprise Risk Management
- Organizational excellence
- Quality Management
- Value-Based Healthcare
- Standards compliance
- Health Insurance
Personal Information
Nationality: Yemen, Wife and Daughter of Saudi citizens
References
- Dr. Riyadh Alshamsan, CEO Advisor, Health Sector Transformation Program, 00966505218661
- Ms. Sofia Macedo, Clinical Leads Director, Centre for National Health Insurance, 00966554491134
- Ms. Ahlam Haddad, Medical and Clinical Affairs, Senior Quality Specialist, King Faisal Specialist Hospital and Research Centre, 00966506170968
Certification
- Certified Governance, Risk Management and Compliance Professional (GRCP), GRC Certify, 11/24
- Certified Manager of Quality/ Organizational Excellence (CMQ), LEORON Institute, 12/23
- Safe Product Owner/ Product Manager in Agile, Scaled Agile Inc, 06/23
- Scrum Master Certified, Scaled Agile Inc, 01/23
- Project Management Professional, GreyCampus, 10/21
- Value-Based Healthcare Implementation, ICHOM/ Capadev LLP, 04/21
- Certified Green Belt six sigma, Anexas Europe, 03/21
- Certified Objective Key Result (OKR) Professional Practitioner, KPI Institute, 11/21
- Certified KPI Professional and Practitioner, KPI Institute, 11/19
Accomplishments
- National Speaker, 33rd Nursing Symposium 'Healthcare Transformation in the kingdom for 2030 Vision', King Khalid Eye Specialist Hospital, Riyadh, KSA, 10/19
- Poster Presentation, 2nd International Quality & Patient Safety Symposium 'Lean thinking; Hospital Wide Printing Optimization Project', King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, 12/17
- Poster Presentation, 2nd International Quality & Patient Safety Symposium 'Association of Patient Experience and Patient Safety Culture', King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, 12/17
- Poster Presentation, 7th Annual Patient Safety Symposium 'Lean thinking; Hospital Wide Printing Optimization Project', Ministry of National Guard, Riyadh, KSA, 03/17
- National Speaker, Perioperative Medicine International Symposium 'Maintain Normothermia PACU', King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, 10/13
Committees
- Agile Scrum Master, Population Health Management full cycle implementation, Centre of National Health Insurance, Riyadh, KSA, 2023
- National training coordinator, Patient Reported Outcomes Measures (PROMS), Executives Committee of five Health Clusters, Ministry of Education and Ministry of Defense, Vision Realization Office, MoH, Riyadh, KSA, 2021
- Coordinator, Executive Committee of the national stroke and CAD Registries, Vision Realization Office, MoH, Riyadh, KSA, 02/20
- Member, National Stroke Registry, Saudi Health Council, Riyadh, KSA, 12/19
- Organizing member, 2nd International Quality & Patient Safety Symposium Committee, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA, 12/17
- Member, Corporate Revenue Cycle Management Committee, King Faisal Specialist Hospital & Research Centre, Riyadh, KSA, 07/17
Timeline
Quality Systems Senior Specialist
Centre for National Health Insurance
02.2021 - Current
Associate Project Manager
Vision Realization Office, MoH
11.2018 - 02.2021
Quality Billing Specialist
King Faisal Specialist Hospital & Research Centre
07.2017 - 11.2018
Acting Quality Data Manager
King Faisal Specialist Hospital and Research Centre
02.2016 - 07.2017
Quality Analyst
King Faisal Specialist Hospital & Research Centre
02.2014 - 02.2016
Staff Registered Nurse
King Faisal Specialist Hospital & Research Centre
04.2011 - 02.2014
- Certified Governance, Risk Management and Compliance Professional (GRCP), GRC Certify, 11/24
- Certified Manager of Quality/ Organizational Excellence (CMQ), LEORON Institute, 12/23
- Safe Product Owner/ Product Manager in Agile, Scaled Agile Inc, 06/23
- Scrum Master Certified, Scaled Agile Inc, 01/23
- Project Management Professional, GreyCampus, 10/21
- Value-Based Healthcare Implementation, ICHOM/ Capadev LLP, 04/21
- Certified Green Belt six sigma, Anexas Europe, 03/21
- Certified Objective Key Result (OKR) Professional Practitioner, KPI Institute, 11/21
- Certified KPI Professional and Practitioner, KPI Institute, 11/19
Master of Science - Public Health, Health System & Quality Management
King Saud Bin Abdulaziz For Health University
Bachelor of Science - General Nursing
King Saud University
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