Clinical Documentation & Quality Improvement Specialist I

Northwestern Medicine; Chicago (IL); On-site; USD 65,000 - 90,000; Full time

Job summary

Northwestern Medicine is seeking a Clinical Quality Documentation Specialist I in Chicago, IL, to enhance the completeness and accuracy of quality data through close collaboration with physicians, nursing staff, and quality committees.

The role applies clinical expertise and national quality standards to drive improvement, act as a change agent, and ensure documentation supports accurate patient characteristics and outcomes measurement.

Qualifications

• Registered Nurse in the State of Illinois
• Bachelor's or Master's degree in nursing
• Minimum 2 years of bedside nursing care with evidence of participation in quality, patient safety, or related initiatives with change management skills
• Strong interpersonal, communication, conflict management, diplomacy and negotiation skills
• Proven leadership to affect positive clinical quality outcomes
• Analytical skills to independently collect, analyze and interpret clinical data
• Basic computer skills and willingness to learn computer applications relative to this position

Responsibilities

• Maintains integrated relationships with business unit and system physician and administrative leaders to advance quality metrics through front-line documentation efforts.
• Rounds daily with physicians and APPs to ensure accurate documentation in the medical record.
• Partners with leadership to develop and implement communication and education to engage physicians and improve processes and outcomes.
• Performs daily medical record reviews and data collection to identify documentation and quality issues and opportunities for improvement.
• Understands clinical documentation in light of national quality metrics (e.g., U.S. News & World Report, Vizient, Leapfrog, CMS Star Rating).
• Collaborates to model and improve the culture of safety and shared improvement across venues.
• Presents updates to operational and medical leadership and interdisciplinary quality committees.
• Communicates with the Clinical Coding Team to support accurate reporting of diagnoses and treatments.
• Participates in professional development and education in clinical quality improvement and patient safety.

Skills

Interpersonal communication

Conflict management

Diplomacy and negotiation

Leadership to affect outcomes

Analytical skills

Basic computer skills

Education

Bachelor's or Master's degree in nursing

Job description

Northwestern Medicine is seeking a Clinical Quality Documentation Specialist I in Chicago, IL, to enhance the completeness and accuracy of quality data through close collaboration with physicians, nursing staff, and quality committees.

The role applies clinical expertise and national quality standards to drive improvement, act as a change agent, and ensure documentation supports accurate patient characteristics and outcomes measurement.