A Clinical Quality Manager ensures that the quality of the work in a clinical environment is consistent and meets government and industry standards as well as customer expectations. Verifies compliance with health and safety regulations. Coordinates all activities related to quality assurance and monitoring and revises existing processes in order to increase efficiency.
Clinical Quality Compliance Consultant Advocate Aurora Health - 3.6 Winston-Salem, NC Job Details Full-time $38.20 - $57.30 an hour 16 hours ago Qualifications RN License Full Job Description
EDUCATION/EXPERIENCE
Graduation from an accredited School of Nursing with a Bachelor's degree in Healthcare of a Business related field (Master's degree preferred) -OR- 10 years nursing experience in an academic medical center 3 years of clinical quality review related work experience preferred 3 years' experience in quality measurement and/or improvement, patient safety, or health science research preferred. Experience working in a complex health care organization (e.g., academic medical center) preferred. LICENSURE, CERTIFICATION, and/or
REGISTRATION
Current license to practice as a Registered Nurse (RN) in the State of applicable state. Certified Professional in Healthcare Quality preferred.
ESSENTIAL FUNCTIONS
1. Facilitates compliance with evolving quality measures including, TJC Oryx Reporting of Core Measures, Leapfrog, CMSs National Hospital Quality Measures, and National Quality Forum quality measurement and reporting requirements, and other benchmarking reporting requirements. 2. Develops both measurement and improvement strategies for assigned performance measures and programs. 3. Oversees clinical review in area of responsibility to ensure complete and accurate data collection and data entry for assigned performance measures and programs/projects within established timeframes. 4. Works with Quality Department leadership to investigate quality concerns or issues arising from external payer reviews, external clinical benchmarking efforts (NSQIP, UHC, Leapfrog, TJC, etc.), or tracking of surveillance of major outcome measures (e.g., mortality, readmission, and reoperation rates). 5. Provides concise clinical quality review findings, develop recommendations for corrective actions and/or improvement opportunities to leadership as warranted, and track the impact of implemented changes. 6. Works with assigned team and quality leaders across the medical center to strengthen clinical documentation and coding to ensure that all DRG related and CPT related coding accurately reflects the patient's complexity and clinical course. Monitors review process for all hospital acquired conditions and publicly reported conditions to ensure accuracy of information provided to regulatory reporting agencies. 7. Works with Quality Assessment Director and Performance Excellence division leaders to manage specified quality and safety related projects as determined by leadership, including developing project timelines, agendas, reports, and presentations to various audiences as appropriate. 8. Establishes effective and collaborative working relationships with members of the hospital community, clinical departments, administrative departments, and quality and safety staff across Wake Forest Baptist Health. 9. Keeps current with data abstraction specifications, emerging trends in hospital quality and reporting initiatives, and integrates key concepts into work. 10. Performs other duties as assigned.
SKILLS/QUALIFICATIONS
Superior organizational and interpersonal skills with ability to work independently. Knowledge of state and federal regulations specific to external reporting mandates Excellent communication and follow up accompanied by the ability to analyze and present data in a way to influence and change behavior Excellent creativity and enthusiasm for developing and implementing new programs High degree of professionalism, discretion, and confidentiality Comfortable interacting with a vast array of administrative and clinical staff, ranging from the Chief Medical Officer and department Chairs, to frontline care providers Experience with performance improvement methods, including statistical concepts and applications Strong project management skills with experience in planning, facilitating, and organizing teams Strong computer skills (Word, Excel, and PowerPoint applications), preferably 2010 version Ability to be flexible accommodating clinician's schedules when early or late meetings are necessary
WORK ENVIRONMENT
: Works in a continually changing work environment. Possible exposure to infectious and contagious diseases. Exposure to radiation hazards. Subject to many interruptions. Subject to irregular hours.
