Quality Improvement Nurse

14 hours ago

Delta, United States Delta Health Full time
Description

Delta Health offers health care professionals and people from all walks of life an opportunity to find fulfillment in their jobs as part of a close-knit team. We pride ourselves on our positive work culture . Our team members understand our fundamental commitment to the community and rally around the motto "Excellence, Every Patient, Every Time." When you embark on a journey with us, you'll take pride in your work and the impact you have, while building a career with focus and purpose.

Coordinates and oversees the hospital's Quality Indicators (core measures). Has the authority to review all documents and other information relevant to quality activities including but not limited to; patient records, billing records, and records/contracts concerning the hospital arrangements with other parties including employees, independent contractors, professionals on staff, medical staff and various quality improvement activities with the Quality Services Department.

Position Responsibilities:

  • Coordinates and managers all components of Medicare (Inpatient Quality Reporting IQR and Outpatient Quality Reporting OQR).
  • Coordinates and performs activities related to the hospital's "Core Measures" as required by CMS.
  • Serves as the contract person for the RWHC (Rural Wisconsin Health Cooperative) which is the vendor for the Inpatient and Outpatient Core Measures.
  • Works with the vendor to identify those charts that "fall out" and verifies the data and resubmitting corrected information as necessary.
  • Coordinates activities related to CMS Chart Validation and works with chart auditors and Medical Records to ensure our validation score does not drop below 80%.
  • Downloads and prepares quarterly Core Measures reports for the Medical Staff Committees and the Board of Directors in a format that is easily understood and useful.
  • Analyzes the data to identify processes to improve hospital and physician performance related to Core Measures.
  • Manages Meaningful Use audit materials to support attestation verification. Participates in audits and prepares for any internal or external audit request.
  • Coordinates inpatient Sepsis reviews and education.
  • Coordinates OPPE for ongoing Physician Review.

Requirements

PRN or "as needed" employees provide a crucial role within the organization, giving departments more flexibility to operate and ensuring that Delta Health provides superior services to our patients.

  • PRN minimum requirement: 2 shifts per month, 1 holiday per year.
  • Registered Nurse with preferably a Bachelor's Degree and a minimum of 3 years' experience in an acute health care setting and at least 4 years' experience in utilization review or quality management.
  • Broad knowledge of hospitals and an understanding of the dynamics of hospital organizational structure.
  • Ability to coordinate activities, organize paper-work, and communicate effectively across the entire organizational chart and to handle controversy.
  • Frequent contact with members of the Medical Staff, outside agencies, patients and families, all requiring sensitivity, tact patience, understanding, and the ability to communicate effectively, verbally and in writing.

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