About The Position

Working under minimal supervision perform and document quality monitoring, medical record review and focused study activities to measure plan performance with clinical, service, and administrative indicators established by the Quality Management Department, regulatory and accrediting bodies.

Requirements

  • Associate’s Degree
  • Graduate of accredited school of nursing (preferred)
  • Bachelor’s Degree in nurse (preferred)
  • 2 years of experience in quality management monitoring activities and/or credentialing/ recredentialing reviews, development, implementation, and evaluation of quality management activities in acute and/or ambulatory health care settings.
  • Excellent verbal and written communication skills.
  • Ability to present and discuss clinical quality of care issues with QM Manager and Medical Director.
  • Strong analytical and problem-solving skills.
  • Strong organizational skills and ability to manage multiple priorities.
  • Ability to function independently with minimal supervision.
  • Basic understanding of QM principles.
  • RN - Licensed Registered Nurse_PA - State of Pennsylvania

Nice To Haves

  • Cardiovascular quality management experience preferred.
  • Knowledge of medical coding preferred.
  • Knowledge of NCQA standards preferred.
  • Basic computer skills in Outlook, MS Word, Excel and Access preferred.

Responsibilities

  • Facilitates and advises internal quality improvement teams.
  • Identifies opportunities for clinical and/or process improvement and facilitates needed changes to improve care.
  • Facilitates and advises Quality Assurance Committees.
  • Analyzes peer review case findings to identify opportunities for improvement.
  • Utilizes project management skills such as Gantt charts, communication plans, process flow diagrams, team building, conflict resolution, problem solving, and facilitation intervention to foster team development and progress toward goals.
  • Incorporates evidence-based best practices or established organization guidelines around proposed interventions.
  • Utilizes appropriate and acceptable intervention behaviors and communication styles in order to effectively facilitate change and process/project improvement.
  • Serves as a resource to network teams to determine data/information needed to measure processes and outcomes. Facilitates the creation of dashboards or appropriate reports.
  • Summarizes data in a clear, concise format for presentation and utilizes appropriate data visualization methods.
  • Ensures alignment and integration of the improvement initiative with applicable regulations, standards, and guidelines from standards setting and accrediting bodies.
  • Demonstrates knowledge of public reporting requirements and Other duties as assigned.

Benefits

  • Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.
  • Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
  • All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps ), have access to medical (including prescription) insurance.
  • For more benefits information, please click here

Stand Out From the Crowd

Upload your resume and get instant feedback on how well it matches this job.

Upload and Match Resume

What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

Associate degree

Number of Employees

1-10 employees

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service