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RN - Quality Improvement Coordinator

Company: Carle Health
Location: Champaign
Posted on: February 15, 2020

Job Description:

Position Summary:The Quality Improvement RN Coordinator works with the Quality Management team, inter-departmentally and with business partners to design, implement, and maintain the highest level of accreditation for National Committee for Quality Assurance (NCQA) and other corporate quality recognition programs; develops quality improvement plans for specific accountable measures that are solution focused, customized to various provider models including Patient Centered Medical Home. This is predominately accomplished through ownership and accountability for data management, analytics, identification of improvement opportunities, and reporting for assigned clinical quality improvement programs/topics. The Quality Improvement Coordinator II provides support and guidance to the overall team and supports leadership in the development, implementation, and monitoring of the QI Program, Quality Plan, and QI Annual Evaluation. Qualifications:EDUCATIONAL REQUIREMENTS College Diploma Nursing. CERTIFICATION & LICENSURE REQUIREMENTS Registered Nurse (RN) Illinois. EXPERIENCE REQUIREMENTS Two years of experience in managed care, ambulatory care or regulatory agency environment; One year of experience in the area of Utilization Management, Case Management or Quality Improvement. OTHER REQUIREMENTS Must be able to work both independently and as a member of the Health Alliance team. Must possess planning and organization skills. Must have a future focus, demonstrate ability to accept and institute change. Must have knowledge of medical records and analysis of processes of clinical care. Must have strong analytical skills and statistical aptitude. Must have strong verbal and written communication skills. Must have teamwork skills in order to work with internal and external departments and individuals. Essential Functions:Function as department subject matter expert on data, databases, and systems used to analyze reported data from various sources, identify opportunities for improvement, plan and recommend action steps and assess results in a continuous cycle of quality improvement. Consult with data reporting team to obtain revised and updated data as needed.Research and review highly technical and analytical documentation related to quality and clinical standards, metrics, and methodology and translate into relevant and actionable language for audiences within the department, other Health Alliance departments, and external business partners.Establish and maintain effective relationships with key individuals from Health Alliance and external clients or vendors to develop a mechanism to identify and resolve QI issues; organize and facilitate meetings and committees.Present quality findings and recommendations to management and internal committees/teams clearly, succinctly and based on accurate outcome measurements when measurements are necessary.Annually review changes in standards for the preparation and maintenance of accreditation through the National Committee for Quality Assurance and implement changes in quality programs on schedule.Collaborate with Star Coordinators to ensure compliance with CMS quality improvement requirements.Provide education to all providers (facilities, DME providers, physicians, mid-level providers and others as part of the clinical team) to improve compliance with nationally recognized clinical guidelines self-management for the chronically ill and increase wellness for all Health Alliance members as measured by HEDIS and other measures.#CB We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

Keywords: Carle Health, Champaign , RN - Quality Improvement Coordinator, Healthcare , Champaign, Illinois

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