Clinical Quality Nurse

Springfield Clinic; Springfield (IL); In loco; USD 65.000 - 90.000; Tempo pieno

Descrizione del lavoro

Springfield Clinic is seeking a Clinical Quality Nurse to conduct clinical care reviews and support actions to improve performance under quality incentive programs. The role involves collaborating with providers and nursing staff to close care gaps and manage attributed patients.

The nurse will validate quality metrics, stay current with incentive program requirements, and travel to multiple clinic locations as needed.

Competenze

• Minimum of five (5) years experience in a health care setting; medical office preferred.
• RN or LPN with license in good standing in the State of Illinois. CPR certification per American Heart Association guidelines required within 30 days of hire.
• Familiarity with EHR clinical products and experience with the implementation of clinical software.

Mansioni

• Participate in the review of quality measures and research literature to determine appropriate supporting documentation.
• Partner with clinics to develop workflows ensuring quality measures are captured and reduce administrative burden.
• Review results with providers and staff and assist in developing interventions to improve performance.
• Conduct follow-up clinical care reviews as needed.
• Travel to assigned sites and collaborate with leadership.
• Comply with Springfield Clinic incident reporting policy and procedures.

Conoscenze

Travel to multiple sites

MS Office proficiency

Strong communication

Leadership skills

Independent worker

Deadline oriented

Payer relations knowledge

Healthcare delivery background

Time management

Strumenti

EHR familiarity

Clinical software implementation

Descrizione del lavoro

The Clinical Quality Nurse is responsible for performing clinical care reviews using criteria outlined by the Clinic's various quality incentive programs (e.g., HEDIS, CMS, etc.). The Clinical Quality Nurse works with the providers and nursing staff to implement actions to improve performance, close gaps in care, and assist with the proactive management of the Clinic's attributed patients. In addition, the Clinical Quality Nurse will assist in the validation of the quality metrics and measures used within the Clinic's quality dashboards.

Job Relationships

Reports to the Quality Incentive Programs Manager

Principal Responsibilities

• Participate in the review of quality measures and research the literature to determine the appropriate supporting documentation under the direction of the Quality Incentive Programs Manager.
• Partner with Clinic's internal departments to develop workflows to ensure quality measures are being captured appropriately and identify opportunities to improve current workflows to reduce the administrative burden on providers and front line staff.
• Work directly with the providers and staff to review the results of clinical care reviews and assist in the development of interventions to improve performance.
• Conduct follow-up clinical care reviews as needed.
• Participate in planning and goal setting for the Department.
• Conduct follow-up clinical data review as needed.
• Traveling to assigned sites (primarily care offices) and working with leadership.
• Participate in planning and goal setting for the Department.
• Comply with the Springfield Clinic incident reporting policy and procedures.
• Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
• Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
• Perform other job duties as assigned.

Working with Agilon/pod leaders to stay current with incentives.

Education/Experience

• Healthcare management or leadership experience preferred.
• Minimum of five (5) years experience in a health care setting; medical office preferred.
• Familiarity with EHR clinical products and experience with the implementation of clinical software.
• Experience in medical record review and statistical data extrapolation.

Licenses/Certificates

• RN or LPN with license in good standing in the State of Illinois. CPR certification per American Heart Association guidelines required within 30 days of hire.

Knowledge, Skills and Abilities

• Ability to travel to multiple Clinic locations.
• Expertise in Microsoft Office products (Word, Excel, Access, Outlook).
• Must be able to meet deadlines and work under pressure while providing a positive image.
• Ability to work independently in all levels of the organization.
• Ability to learn applicable skills and adapt easily to changes in processes or workflow.
• Maintaining relationships with payers to stay current on incentive programs and requirements.
• Excellent organizational, verbal and written communication skills.
• Strong leadership and motivational skills.
• Strong background in business and integrated health care delivery.

Working Environment

• Work in multiple clinic environments.
• Requires sitting and standing for long periods of time.

PHI/Privacy Level

• HIPAA1