Job Description

We are seeking an experienced and dynamic

Quality & Clinical Risk Manager

to take full ownership of all hospital-wide quality, safety, compliance, and risk-related functions. This is a

strategic leadership role

that oversees

everything related to hospital operations and clinical governance

from quality improvement, regulatory inspections, infection control, fire and facility safety, to patient experience, documentation auditing, and staff training.

The role requires an expert leader capable of managing accreditation processes (such as

JCI and DHA

), overseeing internal systems and standards, driving hospital-wide excellence in patient care, and ensuring compliance across every aspect of the organization.

Key ResponsibilitiesQuality Leadership and Strategic Oversight

Lead the hospital's Quality, Safety, Risk, and Compliance functions with a strategic, organization-wide perspective. Set the strategic direction for all quality improvement and patient safety initiatives. Develop, implement, and manage a hospital-wide Quality Plan. Maintain continuous readiness for

JCI accreditation

,

DHA inspections

, and other regulatory body evaluations. Represent the hospital in all external audits, accreditations, and quality forums.

Clinical Governance & Risk Management

Act as the primary liaison for regulatory bodies, ensuring timely and complete compliance with laws, licensing, and accreditation standards. Identify, evaluate, and mitigate clinical and operational risks through a robust hospital-wide Risk Management System. Coordinate root cause analyses (RCA) for adverse events and follow up on the implementation of corrective actions.

Regulatory & Accreditation Compliance

Ensure compliance with

DHA, JCI, MOH

, and other relevant health authorities. Develop regulatory reports, manage all audit responses, and monitor legislative updates. Ensure that policies and procedures are consistently updated and align with evolving standards.

Infection Control & Environmental Safety

Supervise the Infection Prevention and Control (IPC) program, including surveillance, policy implementation, training, and outbreak response. Oversee Environmental, Health and Safety (EHS) practices and protocols across all departments. Conduct routine hospital-wide safety inspections, fire drills, and emergency preparedness programs.

Medical Records and Documentation

Audit clinical documentation and medical records to ensure regulatory compliance and internal standards. Provide training and feedback to clinical staff on proper documentation practices. Ensure privacy, accuracy, and completeness in all patient-related records.

Facility Management Collaboration

Work closely with Facilities and Engineering teams to ensure safety, maintenance, and functionality of the hospital infrastructure. Monitor equipment readiness, maintenance schedules, and facility preparedness for inspections.

Patient Experience & Service Quality

Lead initiatives aimed at enhancing patient satisfaction, service quality, and operational efficiency. Track and respond to patient complaints, safety reports, and incident variances. Analyze patient feedback and implement continuous improvement plans.

Training & Capacity Building

Design and implement hospital-wide training programs on quality, risk, safety, infection control, and fire safety. Conduct orientations and ongoing workshops to promote a culture of continuous improvement and compliance. Support clinical and non-clinical teams with capacity building in accreditation and audit readiness.

Committees and Multidisciplinary Coordination

Lead or actively participate in hospital-wide committees including: Quality & Patient Safety Committee Infection Control Committee Mortality & Morbidity Review Committee Fire and Safety Committee Facility and Biomedical Equipment Committee Coordinate between departments to unify practices, align objectives, and embed a hospital-wide culture of quality and safety.

Required Qualifications

Education:

Bachelor's degree in Healthcare Administration, Nursing, Public Health, or related field; Master's preferred.

Certifications:

CPHQ (Certified Professional in Healthcare Quality) or equivalent certification in Quality or Risk Management.

Experience:

Minimum 5-7 years in a leadership role in hospital quality, risk, and compliance. Proven experience with

JCI and DHA accreditation

processes. Strong knowledge of healthcare laws, regulatory standards, and operational policies. Excellent communication, leadership, and problem-solving skills.
Job Types: Full-time, Contract
Contract length: 24 months

Pay: From AED10,000.00 per month

Education:

Bachelor's (Preferred)
Experience:

JCI : 2 years (Preferred) Quality & Clinical Risk Manager: 5 years (Preferred)
License/Certification:

DHA (Preferred) * CPHQ (Certified Professional in Healthcare Quality) (Preferred)