Last Edit: 11/10/2025
| Role | Definition | Examples of the Type of Roles under this Grouping |
| Administrator | A person responsible for managing the day-to-day operations of a healthcare facility, such as a hospital, clinic, or long-term care facility. The administrator oversees administrative staff, manages budgets and resources, implements policies and procedures, and ensures compliance with regulatory requirements. |
|
| AHQT Point of Contact | This individual is identified by the senior leader as the primary point of contact for the AHQT component of the 13th QIN-QIO SOW. |
|
| Care Manager | A healthcare professional responsible for coordinating and managing the care of patients, often within a specific population or program. Care managers collaborate with patients, families, healthcare providers, and community resources to optimize patient outcomes, promote wellness, and ensure continuity of care. |
|
|
Chronic Kidney Disease Educator |
A Chronic Kidney Disease (CKD) educator specializes in educating patients about CKD, its risk factors, and management strategies. They provide information on lifestyle changes, treatment options, and self-care practices to help patients manage their condition and prevent progression. CKD educators often work in collaboration with healthcare teams to support patient education and engagement. |
|
| Clinician | A healthcare professional who provides direct care to patients |
|
| Compliance | A contact responsible for developing, implementing, and overseeing compliance programs and initiatives within a healthcare organization or corporate healthcare system. The Corporate Compliance Officer ensures adherence to laws, regulations, and ethical standards, conducts compliance audits and investigations, and promotes a culture of integrity and ethical behavior throughout the organization. |
|
| Coordinator | A coordinator is a healthcare professional who organizes and manages the complex, multidisciplinary care required for patients. They serve as a central point of contact for patients, families, and the medical team to ensure all aspects of the patient's treatment plan are effectively integrated. |
|
| Corporate | Primary liaison for corporate communications and initiatives, ensuring alignment with organizational goals and stakeholder engagement. |
|
| COSTO | Contact role for Cost Outlier project |
|
| Data Contact | Contact responsible for managing or transmitting data to or from the IPRO team |
|
|
Dietitian |
A dietician is a healthcare professional who specializes in nutrition and dietetics. They provide evidence-based nutritional guidance to promote health, prevent disease, and manage medical conditions. Dieticians work in various settings, including hospitals, clinics, community health centers, and private practices. They create personalized meal plans, conduct nutritional assessments, and educate patients on healthy eating habits. |
|
| Emergency Department | Healthcare professionals who provide administrative or clinical leadership for hospital emergency department. |
|
| Emergency Management | Primary contact oversees emergency preparedness planning and response. |
|
| File Uploader | Contact responsible for uploading data to the system |
|
|
Healthcare Coalition Lead |
A healthcare coalition lead coordinates and manages a group of healthcare and response organizations within a specific geographic area. They work to enhance emergency preparedness, response capabilities, and overall healthcare system resilience. This role involves collaborating with hospitals, emergency medical services, public health agencies, and other stakeholders to ensure effective communication, resource sharing, and coordinated efforts during emergencies. |
|
| HIT Professional | Professional representing the Health Information Technology department of a facility |
|
|
Home Dialysis Program Manager |
A home dialysis program manager oversees the administration and operation of home dialysis programs. They ensure that patients receive safe and effective dialysis treatment at home, develop policies and procedures, supervise dialysis staff, and provide education and support to patients and their families. This role involves coordinating with healthcare providers and managing resources to maintain high standards of care. |
|
| Hospitalist | A physician specializing in the care of hospitalized patients. Hospitalists manage the medical care of patients during their hospital stay, coordinate treatment plans, communicate with specialists and primary care physicians, and ensure continuity of care from admission to discharge. |
|
| HQIC Liaison | Hospital Quality Improvement Contractor (HQIC) Liaison coordinates quality improvement efforts between the contractor and healthcare facilities to enhance patient care. |
|
| IDR Initiating Party | Independent Dispute Resolution Initiating Party |
|
| IDR Non-Initiating Party | Independent Dispute Resolution Non-Initiating Party |
|
| Infection Prevention | Contact responsible for the practice of preventing and controlling the spread of infections within healthcare settings. Infection control measures include hand hygiene, environmental cleaning, use of personal protective equipment, isolation precautions, vaccination programs, and surveillance for infectious diseases. |
|
| IPG Liaison | Inpatient Psychiatric Facility Quality Reporting Program (IPG) Liaison supports the implementation and reporting requirements of the program, ensuring data accuracy and compliance. |
|
| IPRA | Contact role for Discharge Appeal Project |
|
| Medical Director | Physician who provide leadership and oversight in a medical department or service line within a healthcare organization. A medical director may have responsibilities such as developing clinical protocols, ensuring quality of care, managing physician performance, and representing the department or service line in administrative matters. |
|
| Medical Office Staff | Representative of a medical office whose responsibilities are not medical in nature |
|
| NHSN Contact | Individual who is responsible for accessing and submitting quality and safety data to NHSN. |
|
| Nurse or Nurse Practitioner | A licensed healthcare professional who provides care for patients in a variety of settings, including hospitals, clinics, schools, and workplaces |
|
| Nurse Director | A registered nurse who oversees a nursing department or unit within a healthcare facility. The nurse director is responsible for managing nursing staff, ensuring quality patient care, implementing nursing policies and procedures, and collaborating with other healthcare professionals to achieve organizational goals. |
|
|
Patient/Caregiver Representative |
A patient, family member, or caregiver who works with a healthcare organization to improve the patient experience. |
|
| Patient Engagement | Contact responsible for patient engagement efforts, which is anything focusing on patient outcomes and satisfaction |
|
| PFAC Member | A Patient and Family Advisory Council (PFAC) member is a patient, family member, or caregiver who works with a healthcare organization to improve the patient experience |
|
| Pharmacist | A licensed healthcare professional who specializes in the preparation, dispensing, and management of medications. Pharmacists play a crucial role in ensuring safe and effective medication use, providing medication counseling to patients and healthcare providers, and participating in drug therapy management programs. |
|
| Physician | A licensed medical doctor (MD) or doctor of osteopathic medicine (DO) who diagnoses, treats, and manages illnesses, injuries, and diseases. Physicians may specialize in various medical specialties such as internal medicine, pediatrics, surgery, obstetrics and gynecology, and psychiatry, among others. They provide medical care to patients, prescribe medications, perform procedures, and collaborate with other healthcare professionals to optimize patient outcomes. |
|
| Portal Admin | An outside user assigned to make changes to select information related to Contacts that interact with a Salesforce Portal. |
|
| QINQIO Point of Contact | This individual is identified by the senior leader as the organization’s primary point of contact for the 13th QIN-QIO SOW |
|
| Quality | A healthcare professional responsible for overseeing quality improvement initiatives within a healthcare organization. The quality director develops and implements quality improvement programs, monitors performance metrics, identifies areas for improvement, and ensures compliance with regulatory requirements. |
|
| Senior Leader | This role captures anyone at the senior level of leadership, which may include titles such as CEO, VP, COO, etc. This individual has the authority to sign the Provider Service Agreement |
|
| SHCA Liaison | Contact role for AIMS (AIDS Information Management System) and Medicaid Retrospective Utilization Review program. |
|
| Social Worker | Contact role aimed at addressing a patient's disadvantages or personal issues. |
|
| State/Federal Contact | An individual responsible for representing a state, local, or federal government entity |
|
|
State Surveyor |
A state surveyor, also known as a health facility surveyor, is responsible for inspecting healthcare facilities to ensure compliance with state and federal regulations. They evaluate the quality of care, safety standards, and operational practices in facilities such as hospitals, nursing homes, and clinics. State surveyors play a crucial role in maintaining healthcare standards and protecting patient safety. |
|
|
Surgeon |
A surgeon is a medical doctor who performs operations to treat injuries, diseases, and deformities. Surgeons diagnose conditions, recommend treatments, and perform surgical procedures. They work in hospitals, clinics, and surgical centers, often leading surgical teams and coordinating with other healthcare professionals to provide comprehensive patient care. |
|
| Utilization Manager | A role responsible for overseeing the utilization management program within a healthcare organization. The Director of Utilization Management develops and implements utilization management policies and procedures, monitors the utilization of healthcare services, analyzes data to identify opportunities for improvement, and ensures compliance with regulatory requirements. |
|