Quality Management Spec Ii

JOB DESCRIPTION: Chart review and data abstraction in support of quality measurement, analysis, and improvement across Emory Healthcare. Job responsibilities require detailed/expert knowledge of regulatory requirements/standards which may include core measures, accreditation, registries and other quality metrics. The Quality Management Specialist supports interventions through interdepartmental collaboration and planning, multi-disciplinary communication and implementation/analysis of new care delivery processes impacting quality metrics. Serve as a resource for education and training regarding quality improvement, accreditation standards, internal process improvements and external regulatory requirements
Assist in achieving goals of high quality, cost effective patient care and services, while demonstrating compliance with Joint Commission, CMS and other regulatory agencies. Collaborate with Leadership on recommendations for sustainable processes and system improvements to maintain quality metrics and/or accreditation related objectives. Participate in collaborative efforts with the Director by providing complete, accurate and timely feedback on status of compliance and collaboration for improvement of quality metrics and/or accreditation standards. Reports unusual or questionable situations to CQO/CMO and/or Leadership. Provide daily feedback to frontline caregivers to facilitate the completion of time. Facilitate compliance with quality metrics through collaborative planning, coordination, implementation, and evaluation of new care delivery processes, documentation processes and data. Assists the organization in maintaining preparedness for accreditation and licensure surveys.
Works with manager to formulate plan for professional development. Attends educational in-services as appropriate. Participates in professional activities and organizations to maintain knowledge of current trends, practices, and developments.
Identify specific patient populations requiring Core Measure and registry documentation (ex. HF/AMI/Pneumonia/SCIP, NSQIP, STS, and ACC) utilizing electronic processes and when indicated, concurrent chart reviews. Perform daily chart review and documentation of core measures, registry and selected quality indicators. Responds to requests to data aggregation and analysis.
Serve as a resource to IS for integration of electronic processes impacting quality metrics/data. Participates in patient safety activities as assigned. Performs other duties as requested or assigned.
MINIMUM QUALIFICATIONS: Bachelor's in Nursing. Preferred 5 years, minimum 3 years of experience working in a complex healthcare work environment. In lieu of degree, minimum seven years of experience working in a complex healthcare work environment. Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia Licensing Board. Knowledge of Quality Improvement Methodology, Data Collection and Analysis and Improvement techniques. Position specific experience or certification may be preferred based on various additional duties.
SKILLS REQUIREMENTS: Gain an understanding of the rules & regulations/Structural understanding of internal & external metrics-produce data. Data collection, presentation and dissemination. Understanding of CMS/The Joint Commission rules and compliance requirements.
Understanding of clinical registries sampling and data abstraction rules. Knowledge of reporting requirements for other external agencies that hospitals submit data to including, but not limited to, Anthem, Leapfrog, and United Healthcare. Publicly reported data (understanding of the rules). Understanding how data impacts hospital finance, accreditation, and patient care workflows.
Is familiar and can speak to benchmarks related to performance and registry or external sources. Understanding of TJC/CMS and clinical registry data including how to interpret benchmarks, odds ratios, and statistical control processes. Provides outcomes to OU or service lines in appropriate meetings, as well as providing results on a consistent basis.
Microsoft Office tools (Word, Power Point, Excel, Teams, OneDrive, Sharepoint) required. Proficient in Epic EMR.
SPECIFIC COMPETENCIES: Health Data Analytics: Apply procedures for the governance of data assets (understanding data abstraction specifications). Acquire data from source systems Patient Safety. Identify and report patient safety risks and events Quality Review & Accountability. Execute measure requirements, set and meet internal deadlines
Performance and Process Improvement: Serve as a resource for education and training regarding quality improvement, accreditation standards, internal process improvements and external regulatory requirements. Implement standard PPI methods
Health Data Analytics: Integrate data from internal and external electronic systems to streamline data reporting. Use statistical and visualization methods to show data trends and expected performance
Patient Safety: Collaborate to analyze patient safety risks and events. Quality Review & Accountability