RN Quality Measure Specialist

Banner Health•Phoenix, AL

1d•$35 - $59•Remote

About The Position

The MACRA Department is expanding and seeking RN Quality Measure Specialists to support regulatory and quality reporting initiatives. This fully remote role focuses on validation, abstraction, and submission of clinical quality measures, including MIPS (CQMs, Eligible Clinician and Eligible Hospital eCQMs), Core Measures, and The Joint Commission requirements. This position performs clinical data abstraction and/or validation activities in support of regulatory programs and associated clinical quality measures, including IQR, OQR, IPFQR, Core Measures, TJC, and MIPS (CQM & eCQM). This role applies clinical knowledge and established measure specifications to ensure accurate, complete, and compliant data capture. This position is primarily assigned to abstraction or validation functions with cross-training in both areas. Works within defined workflows and guidelines, contributing to data integrity, audit readiness, and overall quality performance.

Requirements

RN with 5 years acute care experience (ED, ICU, PACU, or similar preferred)
Strong critical thinking and clinical judgment
Ability to work independently in a remote environment while managing priorities and deadlines
Comfort collaborating across teams when needed
Detail-oriented with an interest in quality and regulatory compliance
Working knowledge of Cerner Millennium EHR (Oracle Health's EHR)
Bachelor’s degree in Healthcare or a related field or equivalent level of education and experience.
Must possess a current valid Registered Nurse (RN) license.
Strong clinical background and knowledge as typically obtained through a minimum of three to five years of clinical experience in an acute care setting.
Demonstrated ability to apply critical thinking, analytical reasoning, and problem-solving skills to complex medical cases.
Experience with electronic medical records and clinical documentation.
Strong communication and organizational skills.
Ability to work autonomously within a complex and quickly changing remote environment and navigate a variety of separate computer programs.

Nice To Haves

Working knowledge of quality metric specifications, and clinical coding conventions.
Experience with clinical quality abstraction and/or validation processes.
Experience in high-acuity or critical care environments (e.g., ED, ICU, PACU, or comparable settings).
Experience supporting regulatory programs.
Exposure to report logic, external vendors, or regulatory audits (including IRR/ARR activities).
Experience with Oracle Health EHR (Cerner Millennium).
Experience contributing to process improvement initiatives.
Proficiency with Microsoft Office (Excel).
Additional related education and/or experience preferred.

Responsibilities

Perform clinical validation to ensure measure accuracy and compliance with CMS requirements
Conduct medical record abstraction for assigned measures
Identify and resolve data and logic discrepancies in collaboration with internal teams and external vendors (Oracle Health, Central Utah Informatics)
Support timely and accurate regulatory submissions
Performs clinical data abstraction and validation in alignment with regulatory measure specifications and clinical documentation.
Applies clinical knowledge and established guidelines to support accurate, complete, and consistent data capture.
Identifies data and logic discrepancies and follows defined processes for escalation and resolution.
Adheres to standardized workflows, tools, and documentation requirements to ensure data integrity, regulatory compliance, and audit readiness.
Applies and expands knowledge of assigned regulatory programs and measure specifications.
Contributes to clinical quality data review and validation activities, including report logic review, to ensure data accuracy and alignment with regulatory intent.
Participates in cross-training, knowledge sharing, and quality-related initiatives through data review and collaboration.