Clinical Quality Specialist - Canton Medical Center - Full Time
Job Summary
Shall be a representative of nursing administration and shall perform necessary delegation and coordination of clinical, operational and managerial activities to accomplish the objectives of the assigned area(s) of nursing. Will incorporate responsibilities related to the quality risk and risk score adjustment programs. Assist with the quality improvement review and audit related to potential quality risk issues and adverse events as part of the quality risk program. Will complete chart reviews, documentation of findings, referral for medical director review and required reporting. Will perform healthcare effectiveness data and information set (HEDIS) record reviews and assist with clinical questions related to chart reviews. Must work collaboratively with internal and external departments to ensure all aspects of workflow are completed.
Qualifications
- Graduate from a nationally accredited nursing program preferred, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA).
- Bachelor's degree in nursing preferred.
- Minimum of five years of nursing experience.
- Experience and knowledge of accreditation and regulatory agency standards preferred.
- Quality, medical coding, and/or risk adjustment experience is preferred.
- Currently holds an unencumbered RN license with the State Board of Nursing where the practice of nursing is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state.
- Obtains and subsequently maintains required department specific competencies and certifications.
- Certified Professional in Healthcare Quality (CPHQ) or medical coding certification preferred, but not required.
Benefits
Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits.
About the Role
May included duties as a liaison for accrediting or governing agencies for services such as sleep medicine.
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