Quality Nurse Specialist

WVU Medicine

23d•Onsite

About The Position

Primary responsibility is to assist the Center for Quality Outcomes in the improvement of clinical effectiveness and continual readiness for Joint Commission surveys. Oversees performance improvement activities, regulatory compliance, and other initiatives that lead to effective clinical resource utilization and improvements in quality. Promotes interdisciplinary collaboration and teamwork to promote excellence in patient centered care. Promotes patient education of common disease states and management.

Requirements

Bachelor of Science in Nursing (BSN) AND Three (3) years of clinical experience in a healthcare setting with responsibilities reflecting direct management of patient care including planning, coordination, and delivery of services OR; Associate’s Degree, Nursing (ASN) AND Five (5) years of clinical experience in a healthcare setting with responsibilities reflecting direct management of patient care including planning, coordination, and delivery of services.
Current West Virginia Registered Nurse (RN) Licensure.
Demonstrates computer literacy
Demonstrates assertiveness
Utilizes community and system resources
Must be flexible
Demonstrates effective interpersonal communication
Demonstrates diplomacy
Demonstrates written and verbal skills
Must be able to negotiate
Must be competent in analysis and research methods

Nice To Haves

Advanced degree (MSN, MPH, MPA) preferred.

Responsibilities

Assists in the development and implementation of quality activities and monitors quality indicators for assessment of quality across the continuum of care (ambulatory and inpatient).
Develops and implements mechanisms for ongoing data collection, analysis, and reporting of quality indicators. Initiates mechanisms to ensure timely and accurate reporting of data.
Monitors appropriateness criteria and reports the data for specific procedures and services.
Develops performance improvement initiatives throughout the institution and supports the impetus for sustained performance improvement.
Works collaboratively with the Decision Support personnel and staff for variance tracking.
Works in collaboration with the interdisciplinary health care team to support resource utilization and quality improvement. Utilizes information systems to collect and analyze data.
Identifies strategies for and facilitates teams to achieve appropriate resource utilization. Provides reports and analysis to support team’s goals.
Collects, analyzes, and presents data via internal software systems, external comparative databases and through manual review.
Prepares the institution (ambulatory and inpatient) to successfully meet Joint Commission standards and Centers for Medicare and Medicaid Service (CMS) conditions of participation.
Collects data through survey audits of departments, chart review, and staff interviews.
Analyzes data for trends and for medical staff and institutional compliance with Joint Commission standards and CMS conditions of participation.
Develops and submits reports for appropriate individuals and committees within the organization.
Interacts with faculty and staff to present quality initiative updates, reports, and education.
Assists in the development of appropriate policies, processes, and activities to support continuous readiness for Joint Commission and Centers for Medicare and Medicaid Services.
Assists in the implementation of evidence-based indicators associated with Joint Commission Core Measures and Centers for Medicare Services Scope of Work initiatives and monitors these indicators for compliance.
Develops and implements mechanisms for ongoing monitoring and analysis of evidence-based indicators.
Ensures timely and accurate monitoring of patients’ care of compliance with Joint Commission Core Measures and Centers for Medicare and Medicaid Services Scope of Work initiatives.
Monitors appropriateness criteria and alerts services of patient-centered opportunities.
Obtains orders for appropriate interventions.
Documents evidence of compliance or exclusion criteria for the evidence-based indicators in the medical record. Develops performance improvement initiatives throughout the institution related to evidence-based indicators and supports the impetus for sustained performance improvement.
Analyzes data for trends and for medical staff and institutional compliance with Joint Commission Core Measures and Centers for Medicare and Medicaid Services Scope of Work initiatives.
Interacts with faculty and staff to attain high levels of compliance with Joint Commission Core measures and CMS Scope of Work initiatives.
Assists in the development of appropriate policies, processes, and activities to support compliance with Joint Commission Core Measures and Centers for Medicare and Medicaid Services Scope of Work initiatives.
In conjunction with Insurance Services at West Virginia United Health System, participates in payor-based quality improvement initiatives (QualityBLUE, Ambulatory QualityBLUE).
Presents findings, initiatives, and recommendations to payors.
In conjunction with CMS, QualityBLUE, Get-with-the-Guidelines and other best practices and initiatives, provide and participate in patient education and disease management.
Interact and educate patients on disease states, medical management and possible adverse events (Congestive Heart Failure, Anticoagulation, etc.)
Collaborates with physicians, nursing staff, and other health care providers to ensure comprehensive, coordinated patient and family education. Promotes excellence in practice related to disease state management education by role-modeling advances skills and providing instruction and expertise in dealing with complex problems.