QUALITY-RISK COORDINATOR [United States]


 
Overview:
Our mission is to provide quality healthcare in a safe environment that is sensitive and supportive to the physical, emotional, spiritual and diverse multi-cultural needs of our patients and their loved ones. We advocate the preservation of human dignity in the delivery of our services and programs.
Responsibilities:

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The Quality Coordinator / Abstractor will be responsible for the abstraction and assessment, measurement and reporting of The Joint Commission (TJC) Core Measures, CHART and other assigned clinical data abstraction reported internally or to external agencies. The Quality Coordinator / Abstractor will utilize, understand, and apply specific clinical data definitions and abstraction rules associated with the management of the external benchmarking projects. He/She will act as the primary resource to the Quality Services Department and Clinical Focus Group Performance Improvement leaders and teams for any data abstraction guideline interpretation questions and/or issues related to CMS/TJC projects. He/she will insure the accuracy, integrity and validity of all data reported for internal and external benchmarking, including data transmitted and reported publicly on Qualitycheck.org (TJC), Calhospitalcompare.org (CHART), and Hospitalcompare.gov (CMS). He/she will serve as the Quality Department lead for CDAC Validation to ensure the hospital’s validation scores remain within the CDAC validation thresholds, and that requested charts are reviewed and sent in a timely manner to CDAC. He/she further insures that timely appeal of any cases which do not pass review. The Program Manager for Clinical Abstraction will also insure the integrity and validity of all related information that is used for analyzing services, practice patterns, and protocols of AHMC GEMCH. He/She will work collaboratively with others to promote the strategic goals and mission, vision and values of AHMC GEMCH.
Qualifications:
  • Five years of relevant progressive work experience in clinical healthcare preferred, including direct experience in quality assessment, resource management, and case management.
  • Working knowledge of federal, state, and regulatory requirements in quality assessment, case management, resource management, hospital systems, accreditation, and licensure.
  • Strong professional, organizational, and interpersonal skills required for effective and creative leadership in working with all levels of the organization including physicians, committees, senior management, and trustees, as well as patients and their families.
  • Ability to lead, support, and build on current efforts of various groups working within the department's scope of work.
  • Ability to extensively communicate with outside agencies, and regulators.
  • Possess good analytical and problem solving skills. Ability to work with computerized clinical information systems. Initiative, flexibility, integrity, and diplomacy.
  • Function independently under the guidance of the Director of Quality/Risk Management within the broad scope of department and organization‑wide policies, practices, and common goals.
  • Generally refers specific problems to Director of Quality/Risk Management only when the clarification of operating policies and procedures may be required.
Hospital Description:
Essential functions are those tasks, duties, and responsibilities that comprise the means of accomplishing the job’s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable. Following are the essential functions of the job, along with the corresponding performance standards.
  • Demonstrates the ability to communicate the hospital’s mission, vision, and values, as well as departmental goals, to all staff.
  • Provides leadership and guidance to other leaders and staff in goal setting, problem solving, resource management, and outcome achievement.
  • Defines performance objectives and metrics for the department, and assesses the level of competence of staff in a timely manner
  • Demonstrates a commitment to a healthy work environment by modeling the desired behaviors and encouraging those in others.
  • Demonstrates the ability to cope with and manage change, as well as help others do the same.
  • Collaborates with other departments to create systems and problem solve ongoing issues that impact departmental/organizational goals and/or patient care delivery.
  • Demonstrates fiscal accountability for department resources, and the ability to achieve outcomes within allocated resources
  • Incorporates quality improvement data and/or patient satisfaction data into departmental goals.
  • Demonstrates a clear understanding of regulations applicable to patient care and/or other department functions
Essential functions are those tasks, duties, and responsibilities that comprise the means of accomplishing the job’s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable. Following are the essential functions of the job, along with the corresponding performance standards.
  • Oversees the daily operation of the continuing care/quality improvement department.
  • Participates in educational programs, seminars, and conferences.
  • Is responsible for department’s operational excellence; ensures department delivers quality services in accordance with applicable policies, procedures, and professional standards
  • Effectively communicates departmental, organizational, and industrial information to staff.
  • Attains all agreed to goals and objectives within specified time frames, as part of the organization’s overall mission
  • Follows the hospital exposure control plans/bloodborne and airborne pathogenss all required safety training programs and can describe his or her responsibilities related to general safety, department/service safety, and specific job‑related hazards.

  • Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment
Nonessential functions are those tasks, duties, and responsibilities that are not critical to the performance of the job. Following are the nonessential functions of the job, along with the corresponding performance standards.
  • Initiates and coordinates special projects pertaining to utilization management/quality improvement and continuing care/case management.
  • Member of appropriate hospital committees, both medical staff and operational.
  • Plans and implements the QI program to meet the needs of medical staff and operational departments.
  • Assists in providing educational sessions for medical staff, nursing staff, and other operational departments regarding QA, continuing care case management as needed.
  • Performs other duties as requested by CNO/Director

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