RN Clinical Quality Analyst

Position Details

Reliant Medical Group, Part of Optum
Location: 385 Grove Street, Worcester MA
Department: Risk & Quality Management
Schedule: Full-time, Monday - Friday
Salaried Hybrid environment - must be able to report to the physical office as needed

Primary Responsibilities

• Participates in the Peer Review Program by performing quality case reviews submitted by risk management, incident reports, audits, sentinel events, clinician referrals or any complaints related to quality of care
• Utilizes critical thinking skills when interpreting and incorporating the organization's policies and procedures to assess and evaluate case medical records, including chart review, provider feedback, and any previous reviews completed on the case to identify and address potential individual provider or operational process issues which impact the quality of care delivered at Reliant
• Utilizes critical thinking skills to determine appropriate patient outcome and care ratings based on review findings and communicate the conclusions to providers
• Participates with the development and correction of organizational system issue fixes to ensure compliance with legal and other external regulations/requirements to support the continuous performance improvement of the quality of care and service provided by the organization

Required Qualifications

• Graduate from an accredited school of Nursing and current licensure as a Registered Nurse in Massachusetts
• 5+ years nursing experience in a healthcare setting including hospital medical/surgical or ambulatory care
• Experience utilizing electronic medical records
• Knowledge of various software applications such as Microsoft PowerPoint, Excel, Access, Outlook, etc.

Preferred Qualification

• Demonstrated experience in database management, statistical analysis, and graphics software

Pay and Benefits

• Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.
• In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
• The salary for this role will range from $60,200 - $107,400 annually based on full-time employment.
• We comply with all minimum wage laws as applicable.