Clinic Quality Analyst RN or LPN

Job Description:

Clinic Quality Analyst

The Clinic Quality Analyst supports the Rural Health Clinic operations and quality improvement by driving care gap closures, improving patient outcomes, and ensuring compliance with performance metrics and payer incentive programs. Responsible for ensuring that healthcare providers and the rural health clinic deliver the highest quality care possible by meeting standards of care (including CMS measures, care gap closures, clinic quality measures etc.)

and ensure patient care and documentation needs are met for optimal reimbursement. Analyze data related to clinical performance, identify areas with opportunities for improvement, and develop strategies to address these issues, implement strategies and evaluate effectiveness of these strategies. Work directly with medical professionals and the organization’s leadership team. Collaborate with Rural Health Clinic staff. Leadership, and providers to implement policies and or procedures to improve quality measures.

Strive to improve the quality of patient care through a variety of methods including audits, assessments, evaluations, etc.

• Full time
• Day shift

• Medical/ Dental/ Vision Insurance
• Health Savings Account
• Flex Spending Account/Dependent Care Spending Account
• 403 (b) Retirement Plan- up to 4% employer contribution
• Earned Time Off
• Life Insurance
  - Employer Paid
• Long-Term Disability/ Short-Term Disability-Employer paid
• Voluntary Life & AD&D
• Free 24-hour fitness center
• Hospital Indemnity
• MASA
  - Medical Transportation Solutions

• Identify, track, and prioritize care gaps and quality measures through the Electronic Medical Record and payor data.
• Provide ongoing support to the clinic team by identifying and correcting documentation needs.
• Assist the clinic with identifying patient care opportunities for upcoming scheduled patients.
• Maintain, track, analyze, and correct data of care gap closures and quality measures.
• Concurrent chart auditing to identify opportunities, completeness and accuracy including but not limited to: documentation requirements for reimbursement, standards of care met, adherence to policies, procedures, order sets
• Identify trends and opportunities to determine areas of needs including but not limited to provider educational needs, program development, EHR/documentation changes, revision or development of order sets, policies and/or standard procedures/guidelines, additional reimbursement opportunities
• Review programs and patient care to ensure that medical care is effective, efficient, and in-line with the evidence-based standards of care
• Work with billing department to review current billing processes and identify billing opportunities for additional charges as well as documentation needs for billing and develop and implement necessary actions. Monitor the effectiveness of changes that were implemented
• Participate in quality improvement projects such as developing new methods for measuring quality, data entry, and identifying opportunities for improvement.
• Create reports summarizing findings and providing recommendations for improvements in care or procedures
• Assist in developing protocols, standards, and guidelines for nursing staff and other healthcare workers
• Develop and implement quality improvement plans, track and report quality indicators, and participate in quality improvement initiatives
• Enter opportunities/incidents into the Risk Management software as necessary
• Report data and information to the appropriate leaders and/or committees

• Completion of Health streams education by designated due…