Job Summary:
Manages the data collection for submission to regulatory databases, as well as studies, research, or projects requiring data collection to evaluate practice patterns, interventions, outcomes, and compliance. Assists with the Peer Review process, preparing case summaries, timelines, initial RCA for complicated cases as requested. Is accountable for supervision of Quality Review Specialists and monitoring appropriate staffing and budgets for this area within Organizational Performance. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.
Job Requirements:
Education and Work Experience:
- Bachelor's Degree in a healthcare-related field or equivalent combination of education/related experience: Required
- Master's Degree: Preferred
- Five years' technical experience: Preferred
Licenses/Certifications:
- Basic Life Support (BLS) American Heart Association: Preferred
Essential Functions:
- Develops programs/processes related to Quality Management. Ensures accuracy, completeness, and timeliness of error correction and submission to Premier for the monthly data extraction and upload cycle working closely with the Clinical Data Analyst.
- Participates in quality committees with accountability for distribution of organizational communication. Ensures department is in compliance with current state, federal, and other regulatory requirements. Participates with Performance Improvement Teams as requested. Attends medical staff meetings as requested.
- Provides annual reports regarding performance Improvement and Quality programs. Enters the data into various computer programs and is responsible for running reports as needed. Assures all requirements are met and completed within specified timeframes.
- Manages issue resolution for the abstraction process. Monitors the Clinical Data Abstraction Center (CDAC) medical record validation process using the Qnet program. Validates charts abstracted into Premier for completeness, accuracy, and timeliness in compliance with the specification manual.
- Prepares aggregate trended reports for the medical staff departments and committees. Is knowledgeable of CMS Value Based Purchasing Program.
- Performs other job-related duties as assigned.
