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Clinical Quality Assurance Specialist

1 month ago

Providence, United States Coastal Medical Full time

Summary:
Provides support develop implement monitor and evaluate the work associated with Pay for Performance and other continuous quality improvement initiatives within Coastal Medical. This position will work closely with the quality clinical analytic and IT teams to plan and implement strategies to improve clinical performance. Assists with compliance initiatives to ensure compliance with a range of quality and shared savings programs.

**Responsibilities**:

- Provide guidance and leadership of process improvement initiatives for NCQA Meaningful Use MACRA Coastal Core and other clinical quality programs
- Support the Clinical Quality Team by assisting in the development of strategies for clinical quality programs such as NCQA recognition
- Establish performance indicators to evaluate success criteria and measure practice competency for Meaningful Use
- Auditing of clinical elements for compliance with Coastal Policy examples
- Lab and DI tracking referral tracking pre-visit planning patient access etc.
- Work with IT to optimize the use of the EMR to improve clinical performance and strategize for improving patient care
- Coordination of clinician staff and manager training for Quality Measure Performance Patient Satisfaction and Meaningful Use/MIPS
- Successful submission of NCQA Meaningful Use/PIP CPC Plus and other external reporting for clinical quality
- Participates in the development of program plans the development of strategies and the evaluation of outcomes that promote the delivery of effective patient care and improved clinical performance
- Participate with the Quality Team to assure the clinical elements of Pay for Performance initiatives are implemented in the organization through testing monitoring and evaluating the progress that result in improved process and outcome measures
- Monitor audit and advise on adherence to policies and procedures concerning compliance incentive and quality improvement activities.
- Perform internal audits and review reports of activities that may indicate non-compliance and develop action plans
- Participate on various committees and work groups as assigned

Additional responsibilities as deemed necessary

Other information:
**Education and Experience**
- Bachelor
- s in healthcare related field or Nursing
- If nursing current RN license in good standing
- At least 3 years
- experience in healthcare related position
- At least one years
- experience in the implementation of Quality Improvement initiatives

**Knowledge Skills and Ability**
- Knowledge of NCQA Meaningful Use CMS programs Pay for Performance programs and other continuous quality improvement initiatives
- Knowledge of quality improvement processes
- Experience with quality improvement models and tools
- Experience implementing quality initiatives in a clinical setting
- Excellent time management and communication (oral and written) skills
- Excellent organizational skills with precise attention to detail skills

**Physical Effort and Dexterity**
- Sit and stand for prolonged periods of time
- Work and move among all departments of Coastal Medical group
- Possess a valid driver
- s license & own transportation
- Excellent hand/eye coordination
- Lift up to 15 pounds
- Manual dexterity to operate personal computers and standard office machines and equipment as it pertains to one
- s position

**Visual Acuity Hearing and Speaking**
- To transfer information from paper to computer from computer to computer and to communicate in person and on the telephone

Location: Coastal Medical USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union

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