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Registered Nurse Quality Provider Performance Consultant
4 months ago
Job Description
:The Provider Quality and Practice Transformation Consultant Registered Nurse is responsible for working directly with providers and care teams to build relationships and educate and implement structures and processes in alignment with population health management models.The Consultant will familiarize providers and their care teams with tools, reporting, and best practices and assist in the development of skills necessary to support meaningful changes in the way care is delivered. The incumbent assists providers/practices in utilizing analytic tools and practice level member data to improve coordination of care, quality metric performance, appropriate utilization, patient access, and patient outcomes. The incumbent collaborates with practice teams to create a culture of learning, coordinate activities, review work, exchange information, resolve problems, and proactively identify opportunities for improvement. The Consultant provides on-site and remote support as providers and their practices work with SelectHealth Medical Home. This work requires frequent travel as the consultant visits practices to support with clinical practice improvement and transformation. Provides clinical and nursing expertise and acts as a resource to other SelectHealth and Intermountain stakeholders who are impacted by Medical Home initiatives.
Consults and assesses practice/provider readiness for practice improvement and transformation and assists in clinical process transformation and improvement. Supports clinic leadership in the oversight of clinical practice of assigned practices and provides clinical support within assigned sites. Provides infrastructure and education to empower providers and care teams to achieve desired clinical transformation outcomes. Supports accountability for action items and follow-up on improvement plans. Meets with practice staff based on action plans for improvement, facilitates ongoing discussions, drives progress, and addresses barriers. Proficient in data and terminology necessary for population health management. Expert in Healthcare Effectiveness Data and Information Set (HEDIS), National Committee for Quality Assurance (NCQA), & Centers for Medicare & Medicaid Services (CMS) Stars measure specifications and regulatory requirements. Utilizes clinical knowledge and measure set knowledge to develop clinical materials and tools to support quality improvement and practice transformation. Researches and monitors literature for current best practices. Educates participating practices on best practice related to population health and practice transformation. Develops evidence-based tools for participating practices and trains on use. Guide/coach clinics in practice transformation work to implement a medical home/population health delivery model. Monitor, analyze, and interpret clinical outcomes performance of program participants. Work with clinics to develop action plans for deficiencies. Educate clinic providers and staff on clinical measurement and program specifications (quality, total cost of care, satisfaction). Sets up contracts with Medical Home clinics and ensures regulations are being met. Evaluate clinics for contract compliance, address issues as identified and escalate as needed. May meet with legal and reporting to ensure compliance to contracts. Works with high level professionals to develop agenda, prepare materials, and organize annual best practice symposium events. Audits and reviews accuracy of clinical metrics shared to clinics. Frequent quality assurance audits of measures to ensure accuracy of payout for providers in medical home program. Works closely with the SelectHealth Provider Development team to coordinate provider communication, meetings, outreach, and escalations. Responsible to escalate issues and barriers as well as program outcomes to SelectHealth Senior LeadershipMinimum Qualifications
Bachelor's degree in Nursing (BSN). Degree must be obtained through an accredited institution. Education is verified. Current RN license in the State of Utah 5 years of nursing experience. Project Management or Quality Improvement experience. Experience with basic computer programs, statistical analysis, and quality reviews. Experience working in practice transformation. Experience working in a high-pressure, dynamic, demanding, and ambiguous work environment. Leadership experience including achieving results while working with others. Experience with change management in large organizations. Excellent presentation, interpersonal, and relationship-building skills. High level of proficiency creating executive-facing deliverables.Preferred Qualifications
Master's degree in Nursing or a clinical area from an accredited institution. Experience working with outpatient clinics. Working knowledge of NCQA requirements for Patient Centered Medical Home. Experience consulting within the healthcare setting Experience working directly with physicians including using data to influence physician behavior. Ability to analyze and interpret data and provide education to other customers.Physical Requirements:
Anticipated job posting close date:
07/08/2024Location:
SelectHealth - Las Vegas, SelectHealth - MurrayWork City:
MurrayWork State:
UtahScheduled Weekly Hours:
40The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$ - $We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers, and for our Colorado, Montana, and Kansas based caregivers; and our commitment todiversity, equity, and inclusion.
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
