Clinical Outcomes Specialist
2 weeks ago
At Houston Methodist, the Clinical Outcomes Specialist is responsible for supporting regulatory and/or accreditation quality reporting requirements, internal quality initiatives, clinical outcomes processes, and clinical benchmarking endeavors of the entity.
This includes concurrent and/or retrospective data abstraction, data management, data analysis, report generation, results presentation and dissemination, and education of medical staff, entity staff and management.
PEOPLE ESSENTIAL FUNCTIONS
Communicates and disseminates timely data analysis and findings to management and appropriate entity and/or medical staff committees.
Communicates timely and relevant feedback to team, management, entity, and/or medical staff as it pertains to assignment, errors in coding, performance/process improvement initiatives, ongoing projects and other related issues; follows-up on and closes the loop of each communication to ensure timely resolution or escalation if necessary.
Adheres to agreed upon escalation process for communication within the department, entity and/or medical staff.
SERVICE ESSENTIAL FUNCTIONS
Supports Department with data abstraction for regulatory and/or accreditation requirements and performance/process improvement projects.
Interprets and analyzes data to determine trends, identify potential causative factors and opportunities for improvement.
Incorporates analyses into routine monthly or ad hoc reports, using statistical tools/graphic models appropriate for data and intended audience. Presents the information to various committee or performance improvement teams.
Serves as a resource, consultant, and expert for assigned registry or measure sets for the Department, entity leadership, and staff.
QUALITY/SAFETY ESSENTIAL FUNCTIONS
Accurately abstracts data through concurrent and/or retrospective medical record review; organizes and inputs data into appropriate database in accordance with specifications manual or coding instructions; adheres to volume requirement and submission deadlines; if required, meets registry volume requirement for follow-up phone calls to clinics, patients or families within the required time frame.
Clarifies interpretation of specifications manual/coding instructions/abstraction guidelines with appropriate registry or measure set support team and disseminates information to team, entity and/or medical staff as needed.
Reviews and validates accuracy and completeness of abstracted data on an established and agreed upon schedule and prior to submission; adheres to established department internal and external validation process to ensure quality, accuracy, and integrity of data.
Supports RCAA/FMEA process as requested when patient outcomes suggest possible system failures.
FINANCE ESSENTIAL FUNCTIONS
Manages department resources and assignment effectively and efficiently as evidenced by prudent use of office supplies, timely data abstraction, data entry, and data submission.
Reports case reviews with incorrect diagnosis or procedure code and refers cases to Coding team for review and re-coding as appropriate.
GROWTH/INNOVATION ESSENTIAL FUNCTIONS
Maintains knowledge of guidelines governing data abstraction, regulatory, and accreditation requirements; stays current with clinical knowledge for specialty area by participating in internal or external educational opportunities.
Makes recommendations to team, department, or entity committees on how to improve processes and performance based on registry or clinical guidelines.
This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.
EDUCATION
Bachelor of Science in Nursing required
WORK EXPERIENCE
Three years of direct patient care in acute care hospital or ambulatory environment required
Previous performance improvement experience preferred
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