Clinical Quality Compliance Consultant

Department: 35155 Wake Forest Baptist Medical Center - BCH Pediatrics: Pediatric Trauma Program

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

Schedule Details/Additional Information: Monday - Friday 8:00am - 5:00pm

Pay Range

$38.20 - $57.30

Education/Experience:

• Graduation from an accredited School of Nursing with a Bachelor's degree in Healthcare of a Business related field (Master's degree preferred) -OR- 10 years nursing experience in an academic medical center

• 3 years of clinical quality review related work experience preferred

• 3 years' experience in quality measurement and/or improvement, patient safety, or health science research preferred.

• Experience working in a complex health care organization (e.g., academic medical center) preferred.

Licensure, Certification, and/or Registration:

• Current license to practice as a Registered Nurse (RN) in the State of applicable state.
• Certified Professional in Healthcare Quality preferred.

Essential Functions:

1. Facilitates compliance with evolving quality measures including, TJC Oryx Reporting of Core Measures, Leapfrog, CMSs National Hospital Quality Measures, and National Quality Forum quality measurement and reporting requirements, and other benchmarking reporting requirements.

2. Develops both measurement and improvement strategies for assigned performance measures and programs.

3. Oversees clinical review in area of responsibility to ensure complete and accurate data collection and data entry for assigned performance measures and programs/projects within established timeframes.

4. Works with Quality Department leadership to investigate quality concerns or issues arising from external payer reviews, external clinical benchmarking efforts (NSQIP, UHC, Leapfrog, TJC, etc.), or tracking of surveillance of major outcome measures (e.g., mortality, readmission, and reoperation rates).

5. Provides concise clinical quality review findings, develop recommendations for corrective actions and/or improvement opportunities to leadership as warranted, and track the impact of implemented changes.

6. Works with assigned team and quality leaders across the medical center to strengthen clinical documentation and coding to ensure that all DRG related and CPT related coding accurately reflects the patient's complexity and clinical course. Monitors review process for all hospital acquired conditions and publicly reported conditions to ensure accuracy of information provided to regulatory reporting agencies.

7. Works with Quality Assessment Director and Performance Excellence division leaders to manage specified quality and safety related projects as determined by leadership, including developing project timelines, agendas, reports, and presentations to various audiences as appropriate.

8. Establishes effective and collaborative working relationships with members of the hospital community, clinical departments, administrative departments, and quality and safety staff across Wake Forest Baptist Health.

9. Keeps current with data abstraction specifications, emerging trends in hospital quality and reporting initiatives, and integrates key concepts into work. 10. Performs other duties as assigned.

Skills/Qualifications:

• Superior organizational and interpersonal skills with ability to work independently.
• Knowledge of state and federal regulations specific to external reporting mandates
• Excellent communication and follow up accompanied by the ability to analyze and present data in a way to influence and change behavior
• Excellent creativity and enthusiasm for developing and implementing new programs
• High degree of professionalism, discretion, and confidentiality
• Comfortable interacting with a vast array of administrative and clinical staff, ranging from the Chief Medical Officer and department Chairs, to frontline care providers
• Experience with performance improvement methods, including statistical concepts and applications
• Strong project management skills with experience in planning, facilitating, and organizing teams
• Strong computer skills (Word, Excel, and PowerPoint applications), preferably 2010 version
• Ability to be flexible accommodating clinician's schedules when early or late meetings are necessary

Work Environment

Works in a continually changing work environment. Possible exposure to infectious and contagious diseases. Exposure to radiation hazards. Subject to many interruptions. Subject to irregular hours.

Our Commitment to You

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

Under supervision, works to strengthen Wake Forest Baptist Health's system-wide quality outcomes reporting and improvement activities. Works with leadership to comply with an increasing number of external reporting mandates and improvement initiatives including data collection, data entry, and analysis of quality data. In addition, responsible for data display and interpretation, and the reporting of this data to a wide range of clinical and administrative leaders. Extensive, daily interaction with Directors and staff in the Performance Excellence division is a key component of this role. Participates in a variety of programs and improvement activities across multiple academic and operational departments.