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Quality Assurance RN

5 months ago

Titusville, United States North Brevard Medical Support Full time
Job DescriptionJob DescriptionDepartment:
PMG Specialty Care

Schedule/Status:
8:00am-5:00pm; Full Time

Standard Hours/Week:
40

Location:
Titusville, Port St. John

General Description:
The Quality Assurance Nurse shall fulfill our mission to provide Healing Experiences for Everyone all the Time; organize, schedule, and complete medical record reviews necessary to support quality initiatives and regulatory reporting, including but not limited to HEDIS reporting, CMS Star measures, State-regulated measures, and supplemental data reporting. The position plays an integral role in maximizing patient data to achieve the most advantageous rates to evidence the quality of care provided to patient; is responsible for onboarding clinical Care Partners to perform with clinical excellence; onboards, trains, educates and monitors quality and infection prevention proficiency among the care team. The position shall exemplify the desired Culture of Choice and philosophies of Parrish Healthcare. This position has shared reporting between the Director, PMG Operations and Assistant VP Nursing, Parrish Healthcare.

Key Responsibilities
HEALING COMMUNITIES | GROWTH
  • Assures the achievement of practice dashboard metrics within each strategic pillar (People, Service, Quality, Growth, Finances); takes immediate and effective steps to assure national benchmarks are achieved or sustained; Quarterly Chart Reviews/Quality Withholds on all PMG Providers; work with Parrish Health Network to close all gaps and be the liaison to the PMG Providers to assist them in completing all quality measures for our health care plans.
  • Serves as PMG electronic medical record super-user; onboards new providers and medical assistants; provides ongoing support and training as need.
HEALING EXPERIENCES | SERVICE
  • Responsible for always providing service excellence; holding self and the care team accountable to providing Healing Experiences for Everyone All the Time.
SYSTEM RELIABILITY | QUALITY & SAFETY
  • Organize, schedule, and complete medical record reviews necessary to support quality initiatives and regulatory reporting, including but not limited to HEDIS reporting, CMS Star measures, State-regulated measures, and supplemental data reporting. Maximize patient data to achieve the most advantageous rates to evidence the quality of care provided to patient; Identifies, and takes action to close, gaps in care; navigating patients accordingly; proficient in the use of PMGs electronic health system.
  • Onboard medical assistants to perform with clinical excellence; lead annual competency and skill checks; train, educate, and monitor quality and infection prevention/control proficiency among the care team; hold self and others accountable for quality outcomes.
  • Responsible for the adherence to all Parrish Healthcare policies and procedures as well as regulations and codes established by federal, state, and local governments affecting professional practice and industry regulations. Ensure that reports required by management and/or regulatory agencies are prepared and submitted within established timeframes.
  • Serves as the ADA Coordinator for assigned area(s): knows where the appropriate auxiliary aids are stored and how to operate them. Responsible for ensuring the maintenance, repair, replacement and distribution of such aids. Additionally, the ADA Coordinator is responsible for working with the Human Resources & People Development Departments to ensure that all Care Partners within the practice(s) are trained on the auxiliary aids and services described in the Communications with Sensory Impaired or Language Barrier Patients policy.
CARE PARTNER ENGAGEMENT | PEOPLE
  • Responsible for supporting inclusive, collaborative, healing work environment within which national best/leading-practice standards for employee engagement are achieved as measured by effective performance management, problem-solving and conflict resolution, training and onboarding new care partners, mentoring aspiring care partners; and inspiring care partner commitment to our mission, vision, values and safe care pledge. Maintains skills and knowledge within professional practice of self and assure same among others; able to step in and serve as back up to cover staffing needs as necessary.
COMMUNITY INVESTMENT | FINANCE
  • Responsible for being a good steward of resources and meeting productivity expectations.
Performs similar or related duties as assigned.
Knows fire, disaster and safety procedures and regulations as it pertains to the work area.

Requirements:

Formal Education:
  • Associate degree in nursing required.
Work experience:
  • >3 years relevant experience; HEDIS experience a plus
Required Licenses, Certifications, Registrations:
  • State of Florida RN License
  • Six Sigma Yellow Belt preferred