Quality Nurse Coordinator at CareWell Health – East Orange, New Jersey

Job Summary

As a quality nurse coordinator, your responsibilities involve reviewing processes and improving the daily operation of a medical facility. You evaluate nurse performance to ensure they are providing quality care and develop strategies to make them more effective and efficient. Your duties also require you to document your findings, assemble data, and prepare written reports. A quality nurse coordinator may be asked to investigate claims against the organization and verify that all activities follow government regulations and institutional policies

Essential Functions

• Work with the Director of Quality for external quality audits such as CMS, TJC etc. and prepares audits of required documents.
• Provides recommendations for quality improvement studies including selection of valid and reliable indicators and coordinates monitoring and evaluation activities upon select implementation.
• Analyzes data and prepares concise, accurate and meaningful quality management reports in accordance with Company procedures; defines opportunities for improvement through trend analysis and communicates information appropriately.
• Assist in implementation and monitoring of quality studies including, but not limited to the development and implementation of preventive health and chronic disease outcomes improvement interventions such as newsletter article, member education and outreach interventions, provider education and outreach interventions, medical record review, focus studies and surveys.
• Perform monthly, quarterly, annual and ad hoc medial record reviews including regulatory compliance; Conduct quality of care investigations and using criteria closes case appropriately or refer to Quality Director for further review; prepares cases for Peer Review Committee.
• Educating members and providers on standards of care.
• Leading project initiatives to close gaps in care.

Other Duties

• Associate complies with the following organizational requirements:
  • Attends and participates in department meetings and is accountable for all information shared.
  • Completes mandatory education, annual competencies and department specific education within established timeframes.
  • Completes annual employee health requirements within established timeframes.
  • Maintains license/certification, registration in good standing throughout fiscal year.
  • Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
  • Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
  • Adheres to regulatory agency requirements, survey process and compliance.
  • Complies with established organization and department policies.

Functional/Technical Skills Requirements:

• Comprehensive understanding of operational health care delivery systems and the current health care landscape. Skills and experience with developing competitive business strategies for health care. Skills and experience with the operational aspects of health care technology deployment. Familiarity and comfort with technology-based operational improvement. Health care management or consulting experience preferred.
• Analytics and Strategy: Expertise in developing and executing data-driven approaches to enhancing business decision-making and improving operational performance (preferably in healthcare). Advanced knowledge of business intelligence best practices, familiarity with fact-based management tools and techniques to drive strategies and a continuous improvement culture.
• Communications: Excellent written and verbal communications skills. Ability to take abstract, complex and/or technical information and break it down for a variety of audiences in a way that is meaningful for them.
• Functional Oversight: Issue identification, gap analysis, ability to prioritize business needs and execute solutions.
• Financial Management: Ability to understand financial reports, develop basic financial models, and identify trends, variances, and opportunities.

Minimum Education/Certification:

• Knowledge of local and national quality management and regulatory standards, including reporting.
• Current unrestricted RN license in the state of New Jersey required.
• BSN degree preferred, MSN degree in Nursing preferred.
• Computer skills: MS Word, Excel, Outlook required.
• Medical record review experience preferred.
• Knowledge of NJ quality management and regulatory standards preferred.
• Strong written and oral communication skills required.
• Project Coordination / Project Management experience preferred.

Minimum Work Experience:

• Required 1 years’ experience in quality improvement and/or utilization review in an acute care setting.