Quality Nurse Specialist CCC

About the role

The primary responsibility is to assist in the improvement of clinical effectiveness and continual readiness for Joint Commission surveys. Oversees performance improvement activities, regulatory compliance, and other initiatives that lead to effective clinical resource utilization and improvements in quality.

Responsibilities

• Assists in the development and implementation of quality activities and monitors quality indicators for assessment of quality across the continuum of care (ambulatory and inpatient).
• Develops and implements mechanisms for ongoing data collection, analysis, and reporting of quality indicators.
• Initiates mechanisms to ensure timely and accurate reporting of data.
• Makes sure appropriate criteria are monitored and reported for specific procedures and services.
• Develops performance improvement initiatives throughout the institution and supports the impetus for sustained performance improvement.
• Works collaboratively with the Decision Support personnel and staff for variance tracking.
• Works in collaboration with the interdisciplinary health care team to support resource utilization and quality improvement.
• Utilizes information systems to collect and analyze data.
• Collects, analyzes, and presents data via internal software systems, external comparative databases and through manual review.
• Collects data through survey audits of departments, chart review, and staff interviews.
• Prompts the institution (ambulatory and inpatient) to successfully meet Joint Commission standards and Centers for Medicare and Medicaid Service (CMS) conditions of participation.
• Analyzes data for trends and for medical staff and institutional compliance with Joint Commission standards and CMS conditions of participation.
• Prepares the institution to successfully meet Joint Commission standards and Centers for Medicare and Medicaid Service (CMS) conditions of participation.
• Develops and submits reports for appropriate individuals and committees within the organization.
• Interacts with faculty and staff to present quality initiative updates, reports, and education.
• Aids in the development of appropriate policies, processes, and activities to support continuous readiness for Joint Commission and Centers for Medicare and Medicaid Services.
• In conjunction with Insurance Services, participates in payor-based quality improvement initiatives (QualityBLUE, Ambulatory QualityBLUE).
• Presents findings, initiatives, and recommendations to payors.
• In conjunction with CMS, QualityBLUE, Get-with-the-Guidelines and other best practices and initiatives, provides and participates in patient education and disease management.
• Interacts and educates patients on disease states, medical management and possible adverse events (Congestive Heart Failure, Anticoagulation, etc.).
• Collaborates with physicians, nursing staff, and other health care providers to ensure comprehensive, coordinated patient and family education.
• Promotes excellence in practice related to disease state management education by role-modeling advances skills and providing instruction and expertise in dealing with complex problems.

Qualifications

• Education: Bachelor of Science in Nursing (BSN) AND Three (3) years of clinical experience in a healthcare setting with responsibilities reflecting direct management of patient care including planning, coordination, and delivery of services OR Associate’s Degree in Nursing (ASN) AND Five (5) years of clinical experience in a healthcare setting with responsibilities reflecting direct management of patient care including planning, coordination, and delivery of services.
• Licenses: Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).

Preferred Qualifications

• Education, Certification, and/or Licensure: Advanced degree (MSN, MPH, MPA)