Quality Improvement Nurse

Position Summary

The Quality Improvement Nurse provides clinical leadership to enhance patient care and safety by monitoring healthcare processes, auditing clinical data, and implementing evidence-based improvements. This role focuses on improving clinical workflows, ensuring compliance with regulatory standards, and closing care gaps for patients within the community.

Program Specific Essential Duties and Responsibilities

• Data Analysis & Auditing:
  • Review patient charts, audit clinical records, and review quality metrics to detect care delivery issues and compliance gaps using standardized criteria (e.g., HEDIS, UDS, CMS, ACO metrics).
  • Abstract data to support quality metric performance for UDS, ACO, and managed care plans.
  • Develop and implement quarterly provider peer reviews.
  • Develop and implement non-provider clinical support staff quality and risk management audits.
  • Maintain indicator and peer review/audit databases.
  • Produce reports and graphs of indicator scores and peer review/audit results.
• QI Project Management:
  • Design and implement quality improvement projects (e.g., PI plans, PDSA cycles) aimed at improving clinical outcomes and reducing error rates.
• Clinical Compliance:
  • Monitor adherence to regulatory standards and update clinical policies/procedures and clinical guidelines accordingly.
• Staff Training & Education:
  • Train staff on new care protocols, evidence-based practices, and documentation improvements.
• Performance Metrics Tracking:
  • Collect, analyze, and report on key performance indicators (KPIs) to leadership regarding health center goals.
• Risk Management:
  • Conduct investigations and root cause analyses of patient incidents or near-misses, preparing detailed reports for the risk management team.
• Collaborative Improvement:
  • Work with interdisciplinary teams (physicians, nurses, IT, management) to develop solutions for workflow efficiency.
• Works collaboratively with Director of Quality to produce documents and tools for Quality Council and quality-related meetings, including taking meeting minutes for the Quality Council.
• Participates in Quality Council meetings and quality-related meetings.

Qualifications and Education Requirements

• One of the following combinations of education and employment experience must be met in order to be considered for the position:
• Education: Bachelor of Science in Nursing (BSN) preferred; Associate Degree in Nursing (ADN) with relevant experience accepted.
• Licensure: Valid Registered Nurse (RN) license in the state of practice. Current BLS/CPR certification required.
• Experience: Minimum 3 years of clinical nursing experience, with 2-3 years in a quality assurance or improvement role preferred.
• Certifications: CPHQ (Certified Professional in Healthcare Quality) is a plus.

Skills

• Proficiency with Electronic Medical Record (EMR) systems.
• Excellent computer skills (Microsoft Word, Excel, Powerpoint, and Outlook).
• Strong knowledge of QI methodologies (e.g., PDSA, Root Cause Analysis).
• Excellent analytical and data interpretation skills (Epic reporting bench experience is preferred).
• Effective verbal and written communication skills.
• Motivational Interviewing skills

Reports to

Director of Quality Improvement and IT