RN - Clinical Quality Abstractor

HealthPartners•Saint Louis, MN

4d•Hybrid

About The Position

HealthPartners is looking to hire an RN - Clinical Quality Abstractor to join our Quality Reporting and Analytics Team! This role is responsible for leading and performing clinical data abstraction, analysis, and reporting activities that support regulatory compliance and organizational quality goals. As a system services role, this position supports clinical quality initiatives across six hospitals within the health system. This role ensures accurate and timely collection, validation, interpretation, and submission of complex clinical quality data required by CMS, Joint Commission, state and federal agencies, and internal stakeholders. The Clinical Quality Abstractor identifies trends, analyzes performance variances, and develops actionable reports and insights to support quality improvement initiatives and enhance patient outcomes. Working collaboratively with quality, clinical, informatics, and physician leaders, this position plays a key role in monitoring performance and advancing organizational quality objectives. Successful candidates will demonstrate strong critical thinking and analytical skills, a thorough understanding of healthcare quality measures and regulatory requirements, and the ability to work independently while managing multiple priorities in a fast-paced environment. This position reports to the Manager, Quality Reporting and Analytics and is part of a collaborative team of eight quality professionals dedicated to advancing clinical excellence and continuous quality improvement across the organization.

Requirements

Associate degree in Nursing (ADN) required.
Two (2) years of acute care nursing experience in a hospital setting
Experience with healthcare quality measures, quality reporting, regulatory requirements, and performance improvement initiatives
Current, unrestricted Registered Nurse (RN) license in Minnesota and/or Wisconsin
Demonstrated ability to analyze and interpret complex clinical data, quality measure specifications, and regulatory requirements.
Strong critical thinking, analytical, and research skills
Advanced computer proficiency with the ability to learn and utilize multiple data and reporting systems.
Effective problem-solving and decision-making skills
Proven ability to build and maintain collaborative relationships with internal and external stakeholders.
Excellent verbal and written communication skills with the ability to present information clearly to diverse audiences.

Nice To Haves

Bachelor’s degree in Nursing (BSN)
Three (3) or more years of quality improvement, clinical analytics, healthcare data analysis, or quality reporting experience in a healthcare setting
Experience with healthcare quality measure abstraction, reporting, performance monitoring, and regulatory compliance requirements
Knowledge of CMS, The Joint Commission, and other state and federal quality reporting programs
Project management, healthcare informatics, and/or quality improvement methodology experience
Demonstrated ability to analyze and interpret complex clinical data, quality measure specifications, and regulatory requirements.
In-depth understanding of healthcare quality measures, performance metrics, and regulatory reporting standards
Advanced proficiency in project management principles, quality improvement methodologies, and/or healthcare informatics tools and processes
Ability to effectively partner with clinical, operational, and administrative leaders across departments to drive quality initiatives and achieve performance goals.
Experience leading efforts to maintain, improve, and sustain quality and performance metrics.
Advanced computer proficiency and experience working with electronic health records, databases, and reporting systems.
Advanced ability to learn, navigate, and utilize a variety of reporting and data analysis tools.
Strong problem-solving, decision-making, and critical thinking skills
Exceptional interpersonal skills with the ability to build and maintain effective relationships with internal and external stakeholders.
Excellent verbal and written communication skills, including the ability to present complex information to diverse audiences.

Responsibilities

Utilize clinical expertise to identify and review medical records of patients that qualify for measure data abstraction.
Complete chart abstraction according to internal and external reporting requirements and regulatory standards.
Adhere to measure specifications established by regulatory agencies.
Complete entry of abstracted data into appropriate systems and databases and ensure data integrity.
Enter and submit data to external regulatory agencies through identified tools, including third-party vendors, ensuring that data integrity, measure adherence, and privacy are maintained.
Communicate regularly with internal clinical champions of the various reporting requirements to collaborate on improvement strategies.
Coordinate and validate external chart audits required by regulatory agencies.
Create reports, utilizing graphical/statistical display of data, with summaries designed for the audiences of the report.
Share data with key stakeholders including opportunities for improvement on a case-by-case basis along with monthly and quarterly summary reports.
Maintain strong expertise in reporting requirements and keep abreast of ongoing changes to the measures.
Communicate changes in guidelines to appropriate internal stakeholders, medical staff, and leadership.
Identify opportunities for improvement within the abstraction process to increase quality and efficiency.
Collate and review materials to be sent for data validation in accordance with regulatory requirements.
Proactively manage the abstraction process and timelines to ensure all abstractions and changes are complete before submission deadlines.
Monitor quality outcomes and evaluate trends.
Provide interpretation of quality measure specifications to support continuous performance improvement.
Provide consultation and support to informatics, clinical, and operational process improvement teams: Identify and recommend process improvements.
Identify and recommend documentation improvements.
Leverage clinical expertise to support medical staff in review of all patient mortalities for various units.
Review and create death narratives and summaries in support of quality initiatives and physician case reviews.
Provide support in reviewing patient safety events and determine classification and trending per defined processes.
Implement program initiatives.
Monitor and maintain compliance with regulatory requirements.
Participate in state and regional quality measurement activities.
Monitor national and statewide trends in quality measurement.
Plan and implement strategies for ongoing quality measure program development and improvement.
Other duties as assigned.