Quality and Safety Specialist RN

JOB SUMMARY

The Clinical Quality Specialist is responsible for collecting, analyzing and reporting clinical data elements on eligible cases as required by state and federal regulatory bodies and accrediting organizations as well as actively engaging in quality improvement and compliance processes.

QUALIFICATIONS

• Five years of clinical nursing experience and/or experience with data abstraction from medical records, analyzing and interpreting processes, clinical outcomes, and costs of care
• Other required skills include excellent written and verbal communication as well as working knowledge of computer software (Microsoft Word and Excel) and web-based applications.
• Prior experience with clinical chart review, Medial Peer Review, and abstraction is preferred.
• Bachelor's degree in health care administration, nursing, or a related clinical field preferred
• RN required.

RESPONSIBILITIES:

• Conduct thorough reviews of patient medical records, treatment plans, and clinical documentation to assess compliance with established quality standards and regulatory requirements.
• Submits data required by the organization, as well as state and federal requirements.
• Reviews clinical data and performance metrics to identify trends, patterns, and areas of improvement in healthcare delivery and patient outcomes.
• Collaborate with interdisciplinary teams, including physicians, nurses, administrators, and quality improvement specialists, with quality improvement initiatives.
• Provide feedback and recommendations to healthcare providers and staff regarding best practices, quality improvement strategies, and compliance with clinical guidelines.
• Participate in audits, investigations, and root cause analysis to address identified quality issues and prevent recurrence.
• Develop and maintain documentation of quality review findings, action plans, and outcomes by organizational policies and regulatory guidelines.
• Facilitate training sessions and educational programs to promote awareness of quality improvement principles and ensure staff competency in clinical documentation and quality standards.
• Stays abreast of changes in healthcare regulations, accreditation standards, and quality improvement methodologies to ensure compliance and continuous enhancement of clinical quality initiatives.
• Actively participates in achieving departmental goals.
• Conducts the following functions of Medical Staff Peer Review: Coordinates reviews with the Medical Peer Review Chairman, Researches and compiles Medical Staff Peer Review data, completes minutes, and communicates findings to the physicians.
• Oversees the physician quality review process. Collects data from other sources to complete the Medial Quality Profile per the credentialing cycle.
• Assists the Quality Director with other projects as requested