Clinical Quality Compliance Consultant Job High Point area,North Carolina USA,Healthcare

Department: 36200 High Point Medical Center - Trauma Services

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

Schedule Details/Additional Information: M-F Day shift

Pay Range $37.50 - $56.25

EDUCATION/

EXPERIENCE:

Graduation from an accredited School of Nursing with a Bachelor's degree in Healthcare of a Business-related field; or, ten years nursing experience in an academic medical center and three years of clinical quality review related work experience required;
Master's degree preferred.

Three 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:

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.

Develops both measurement and improvement strategies for assigned performance measures and programs.

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 time frames.

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).

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.

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.

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.

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.

Keeps current with data abstraction specifications, emerging trends in hospital quality and reporting initiatives, and integrates key concepts into work.

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

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

PHYSICAL REQUIREMENTS: Standing, Walking, Sitting, Bending, Reaching with arms, Finger and hand dexterity, Talking, Hearing, Seeing Lifting, carrying, pushing and or pulling: 20 lbs. maximum

Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work.

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