Clinical Quality Compliance Consultant

Job description

Department: 35155 Wake Forest Baptist Medical Center - BCH Pediatrics: Pediatric Trauma Program Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Monday - Friday 8:00am - 5:00pm Pay Range $38.20 - $57.30 EDUCATION/EXPERIENCE: Graduation from an accredited School of Nursing with a Bachelor's degree in Healthcare of a Business related field (Master's degree preferred) -OR- 10 years nursing experience in an academic medical center 3 years of clinical quality review related work experience preferred 3 years' experience in quality measurement and/or improvement, patient safety, or health science research preferred. Experience working in a complex health care organization (e.g., academic medical center) preferred. LICENSURE, CERTIFICATION, and/or REGISTRATION: Current license to practice as a Registered Nurse (RN) in the State of applicable state. Certified Professional in Healthcare Quality preferred. ESSENTIAL FUNCTIONS: 1. Facilitates compliance with evolving quality measures including, TJC Oryx Reporting of Core Measures, Leapfrog, CMSs National Hospital Quality Measures, and National Quality Forum quality measurement and reporting requirements, and other benchmarking reporting requirements. 2. Develops both measurement and improvement strategies for assigned performance measures and programs. 3. Oversees clinical review in area of responsibility to ensure complete and accurate data collection and data entry for assigned performance measures and programs/projects within established timeframes. 4. Works with Quality Department leadership to investigate quality concerns or issues arising from external payer reviews, external clinical benchmarking efforts (NSQIP, UHC, Leapfrog, TJC, etc.), or tracking of surveillance of major outcome measures (e.g., mortality, readmission, and reoperation rates). 5. Provides concise clinical quality review findings, develop recommendations for corrective actions and/or improvement opportunities to leadership as warranted, and track the impact of implemented changes. 6. Works with assigned team and quality leaders across the medical center to strengthen clinical documentation and coding to ensure that all DRG related and CPT related coding accurately reflects the patient's complexity and clinical course. Monitors review process for all hospital acquired conditions and publicly reported conditions to ensure accuracy of information provided to regulatory reporting agencies. 7. Works with Quality Assessment Director and Performance Excellence division leaders to manage specified quality and safety related projects as determined by leadership, including developing project timelines, agendas, reports, and presentations to various audiences as appropriate. 8. Establishes effective and collaborative working relationships with members of the hospital community, clinical departments, administrative departments, and quality and safety staff across Wake Forest Baptist Health. 9. Keeps current with data abstraction specifications, emerging trends in hospital quality and reporting initiatives, and integrates key concepts into work. 10. Performs other duties as assigned. SKILLS/QUALIFICATIONS: Superior organizational and interpersonal skills with ability to work independently. Knowledge of state and federal regulations specific to external reporting mandates Excellent communication and follow up accompanied by the ability to analyze and present data in a way to influence and change behavior Excellent creativity and enthusiasm for developing and implementing new programs High degree of professionalism, discretion, and confidentiality Comfortable interacting with a vast array of administrative and clinical staff, ranging from the Chief Medical Officer and department Chairs, to frontline care providers Experience with performance improvement methods, including statistical concepts and applications Strong project management skills with experience in planning, facilitating, and organizing teams Strong computer skills (Word, Excel, and PowerPoint applications), preferably 2010 version Ability to be flexible accommodating clinician's schedules when early or late meetings are necessary WORK ENVIRONMENT : Works in a continually changing work environment. Possible exposure to infectious and contagious diseases. Exposure to radiation hazards. Subject to many interruptions. Subject to irregular hours. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.