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Quality Management RN

Company: Dignity Health Management Services Organization
Location: Santa Cruz
Posted on: January 7, 2022

Job Description:

Dignity Health Medical Network (DHMN) and Santa Cruz Quality Care Network are local, physician led networks of healthcare providers and hospitals working together to provide patients with a team-based approach to care which is innovative and inclusive. We are committed to bringing quality health care, expertise, and value to our patients by focusing on patients' access to prevention, care coordination and chronic condition management. A critical member of this team-based quality focused care is the Quality Management Nurse. The Quality Management Nurse will work closely and collaboratively with outpatient and inpatient partners to improve the quality of the care delivered across the care continuum.
DHMN-SC and SCQCN are supported by Dignity Health Management Services (Dignity Health MSO). The purpose Dignity Health MSO is to build a system-wide integrated physician-centric, full-service management service organization structure. Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
Position Summary:
The Quality Management (QM) Nurse provides support to Dignity Health MSO/Clinically Integrated (CI) Program through continuous interaction and education with the participating physicians and mid-levels providers, as well as statewide hospital and Dignity Health MSO/CIN QM staff.
Responsibilities may include:

  • Serve as a key interface and liaison for the local participating physicians through collaboration with the Executive Director, Physician Practice Liaison, QM Nurses and other key members of the leadership team.
  • Responsible for physician education and training on processes and workflow related to clinical initiatives undertaken as a part of the Dignity Health MSO/CI Program, including CPTII and HCPCS coding, documenting quality data in paper and electronic charts, and reporting via the dashboard. This may require travel to provide on-site training in physician offices.
  • Working closely with Physician Practice Liaison to provide physician office staff education regarding support for physician in implementing clinical initiatives undertaken within the physician's area of specialty.
  • Collaborate with Physician Practice Liaison and QM Nurses by developing proficiency in understanding quality data extracts and reporting.
  • Collaborate with the Physician Practice Liaison and QM Nurses in analysis, monitoring and interpretation of ambulatory clinical quality data, using dashboard reports.
  • Provide one-on-one education on use of dashboard reports and other communications as appropriate to identify potential improvements and assist physicians in understanding methods and processes required to achieve measurable results.
  • Collaborate with the Director, CIN Executive Directors and Chief Medical Officer (CMO) Medical Director in preparing analyses, as well as monitoring, interpreting, and educating on results of clinical (ambulatory and hospital) quality, cost and utilization data.
  • Responsible for monitoring and evaluating physician compliance and performance with quality standards, as identified in weekly, monthly and quarterly reports and provide feedback to the CIN Executive Director.
  • Perform patient chart review to reconcile quality reporting results with chart documentation, using a sampling methodology approved by the Dignity Health MSO/CIN Board of Managers.
  • Provide leadership with support on performance improvement and development of remediation plans at the local service area level.
  • Support CA marketing and communications with materials relating to disease management programs.
  • Attend local quality management committee meetings, if requested.
  • Other duties as assigned.
    We're looking for a dynamic and highly motivated person with the ability to inspire and lead people, as well as communicate effectively with employees, Physicians, other Management Service Organization Administrators and Hospital staff.Minimum Qualifications:

    • Minimum 6 months experience in either an acute care or ambulatory / clinic care setting. Must possess experience navigating through patient information in an electronic medical record (EMR).
    • Clear and current CA Registered Nurse (RN) license.
    • Must be able to communicate clearly and concisely with all levels of individuals, sometimes in stressful situations.
      Preferred Qualifications:

      • Minimum 2 years experience in a quality management program in a managed care/health plan, IPA, hospital settings.
      • Previous ambulatory/clinic experience strongly preferred.
      • Possess a keen working knowledge of Medical Management process improvement activities (QM Programs, Pay-for Performance measures), including analysis of qualitative and quantitative clinical data concerning patience outcomes, to ensure the highest quality care is documented consistent with the CI Program guidelines.
      • Experience navigating through patient information in an Electronic Medical Record (EMR) application in the ambulatory setting.

Keywords: Dignity Health Management Services Organization, Santa Cruz , Quality Management RN, Executive , Santa Cruz, California

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