RN Quality Improvement Specialist

3 days ago


Beverly Hills, California, United States Cedars-Sinai Full time
Job Description

The Quality Improvement Coordinator will assess, analyze, and recommend quality and clinical performance improvement processes to ensure the highest standards of quality care are achieved. This role will provide clinical expertise to assist with case-finding, identification of opportunities, and performance improvement activities. The position will also measure performance and identify opportunities to enhance performance in value-based systems of care.

Key Responsibilities:
  • Identify and prioritize clinical cases for follow-up and escalation of services.
  • Perform daily chart abstraction and present patient cases to a multi-disciplinary team with possible care suggestions.
  • Engage with care managers, social workers, physicians, external vendors, and other stakeholders to ensure continuity of care and follow-through on plan of care.
  • Draft correspondence to patients or external vendors on behalf of the care management team or individual physicians.
  • Aggregate and clinically analyze quality and value metric data in support of Medical Directors/Chairs of specific departments.
  • Perform in-depth analysis of individual cases and trend analysis across the entire population of patients.
  • Create clinical quality and value dashboards and action reports in support of performance improvement activities.
  • Develop slide decks and other communication tools and make periodic presentations to share trend information with key stakeholders.
  • Lead and facilitate daily, weekly, and ad-hoc meetings discussing patient care.
  • Participate in Performance Improvement activities to improve care delivery, clinical outcomes, and clinical efficiency.
  • Support HEDIS, pay-for-performance, ACO, and other clinical pay-for-performance and pay-for-value programs.
  • Assist in preparing for and responding to accreditation and regulatory agencies or surveys.
Qualifications:
  • Bachelor's Degree in Nursing required.
  • Master's Degree in Nursing preferred.
  • Valid California RN license required.
  • Two (2) years of prior clinical experience in an acute or ambulatory healthcare setting required.
  • Two (2) years of experience in support of quality improvement, process improvement, or total quality measurement preferred.


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