Registered Nurse-Quality of Care

Registered Nurse-Quality of Care---------------------------------------------------------------The Registered Nurse - Quality of Care main function is to manage internal quality of care referrals and support other quality efforts under Clinical Services and Care Oregon Quality Health Outcomes quality initiatives.
** Estimated Hiring Range:**$ - $
** Bonus Target:
** Bonus - SIP Target, 5% Annual Current Care Oregon Employees:
Please use the internal Workday site to submit an application for this job.

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** Essential Responsibilities
*** Complete Quality of Care reviews.
* Work closely with the director of Quality of Care to ensure quality and clinical issues are addressed in a timely and thorough manner.
* Maintain accurate and complete documentation for files related to quality of care.
* Utilize enterprise tools such as QNXT, Sharepoint and smart sheets to aid in quality monitoring.
* Coordinate and facilitate risk reduction strategies for quality and patient safety issues when opportunities are identified.
* Collaborate with other departments in ensuring quality of care process is working effectively.
* Conduct annual and other trainings as needed.
* Coordinate and facilitate risk reduction strategies for quality and patient safety issues when opportunities are identified.
* Take lead in the implementation and ongoing administration of health improvement programs and provide ongoing feedback to Quality of Care Director and others as appropriate.
* Identify education/ training programs for network providers, members, other health care workers and Care Oregon staff in support of appeals and grievance process.
* Develop and monitor a tracking system to ensure accuracy of data, tracking and trending of providers with quality of care issues and other possible data sources related to clinical quality.
* Provide clinical expertise to other department members, in evaluation of program outcomes, providing input for program activities.
* Ability to apply CMS, OAR, Contract Requirements and other regulatory standards when performing work.
* Apply the Equity First approach when conducting work and participate in helping to develop and implement the Equity First approach.
* Participate in committees such as contract review, peer review and quality oversight as needed.
* Participate in Provider site visits as needed.###
** Experience and/or Education
** Required* Minimum 3 years of experience as an RN in the healthcare industry
* Current unrestricted license as a registered nurse in the State of Oregon  Preferred
* Bachelor’s degree in Nursing
* Prior primary care and/or specialty clinic practice experience and behavioral health experience highly desired
* RN experience with quality improvement, population health and/or case management## Knowledge,

Skills and Abilities

Required Knowledge
* Knowledge of or desire to learn about current clinical practices specifically issues related to quality of care for our members

Skills and Abilities

* Ability to efficiently glean clinical information from a medical record, or other specialized software, and save supporting documentation in appropriate data management tool
* Critical thinking skills
* Strong attention to detail
* Competency with computers and software programs, e.g. PDF, MS Outlook, Word, Excel and EMR systems
* Ability to learn and adapt to new EMR systems, software programs, specification changes and deadlines
* Ability to maintain strict confidentiality of protected health information
* Awareness of the social determinants of health impacting Care Oregon members and approaching interactions with clinics, members or Care Oregon embedded staff with kindness and friendliness
* Ability to work in an environment with…