UnityPoint Health

  • Clinical Quality Specialist

    Requisition ID
    2018-50837
    Category
    Quality
    Location
    US-IL-Rock Island
    Address
    2701 17th St
    Affiliate
    6020 UnityPoint Health QC Trinity
    City
    Rock Island
    Department
    Quality Improvement
    State
    IL
    FTE
    .01
    FLSA
    Non-Exempt
    Scheduled Hours/Shift
    Monday - Friday days, variable
    Work Type (Portal Searching)
    As Needed
  • Overview

    The Clinical Quality Specialist is responsible for the review, abstraction, compilation, evaluation, analysis, communication, and reporting of clinical quality measures data. The results and findings are distributed to regulatory agencies and to all levels of Trinity leadership, including the Board of Directors, for performance improvement purposes.

    Responsibilities

    JOB DUTIES and RESPONSIBILITIES:

    • Reviews patient records and evaluates the clinical quality of care based on the federal accreditation and regulatory requirements.
    • Monitors data related to the clinical quality measures identifying opportunities for improvement.
    • Performs and coordinates the review, abstraction, compilation, evaluation, analysis, and reporting of data for CMS/TJC hospital inpatient and outpatient quality measures Prepares, analyzes, and presents requested reports regarding patient outcomes data involving the hospital, physicians, service lines, etc. utilizing Premier, Quality Net or other databases. 
    • Serves as the liaison for Premier, Quality Net, and other databases. 
    • Serves as the backup Administrator for Premier, QualityNet and other databases.
    • Ensures reliability and validity of the national quality measure data and able to maintain 90% proficiency in validation scores.
    • Facilitates timely submission of national quality measure data to Premier and other potential databases to ensure that CMS, TJC, & IHA quarterly deadlines are met.
    • Serves as a resource to peers, colleagues, management, and medical staff regarding requirements of national quality measures.
    • Maintains a current working knowledge relative to state and federal standards and regulatory requirements (i.e., CMS Conditions of Participation, The Joint Commission standards, state hospital licensure, etc.).
    • Assists with Clinical Data Abstraction audits. 
    • Aggregates data and maintains database for national quality measure findings.
    • Displays data in formats which will facilitate data analysis and follow-up.
    • Revises data elements and reporting formats as needed to meet the complex data needs of the hospital.
    • Works closely with the Health Information Management, Clinical Informatics, and Coding Departments to verify the accuracy of data.
    • Assures that all of the information generated and circulated is treated with the strictest confidentiality.
    • Identifies significant patterns, profiles, and trends and maintains appropriate records.
    • Actively fosters an organizational culture that is based on collaboration, partnership, innovation, customer service, driving change, and teamwork.
    • Facilitates data analysis, trending, reporting, and presentation on individual and departmental statistics.
    • Provides feedback related to national quality measure compliance issues to leadership, physicians, and committees.
    • Maintains current knowledge of national quality measures and keeps current on all changes related to national quality measure requirements by attending webcasts and other educational programs. 
    • Completes special projects and tasks as assigned.

    Qualifications

    MINIMUM QUALIFICATIONS: A. EDUCATION, TRAINING & EXPERIENCE: Completion of 4 year accredited Health Information Management Program, Bachelor of Science in Nursing, or other related health field or equivalent experience. 3-5 years experience in data abstraction and analysis. Experience with EPIC or other electronic health record. Knowledge of performance improvement methodologies, CMS Conditions of Participation, Joint Commission Standards, ICD-10 codes, CPT codes, and MS-DRG codes preferred. Clinical experience of 4-5 years in area of health specialty preferred.

     

     KNOWLEDGE, ABILITIES & SKILLS: Working knowledge of computer operations, electronic health records, report writing, database management, and excel. Advanced verbal and written communication and presentation skills. Ability to communicate efficiently and effectively to multiple groups and provide excellent customer service. Ability to demonstrate sound judgement and attention to detail. Ability to work independently as well as with diverse teams and individuals. Critical thinking skills to abstract data based on complex guidelines. Knowledge of the human anatomy, physiology, medical terminology and medications. Willingness to learn new software applications for data abstraction, analysis, reporting, and monitoring.

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