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Clinical Quality Manager

Clinical Quality Manager

Requisition ID 
2018-5507
# of Openings 
1
Address 
100 Front Street
Job Locations 
US-MA-Worcester
Posted Date 
5/11/2018
Category 
Management
Department 
RISK MANAGEMENT
Job Code 
MM42

More information about this job

Overview

Glob Top Places to WOrk 17

 

Reliant Medical Group is seeking a Clinical Quality Manager to join our exciting and innovative organization!

 

Full Time: 40 hours

Hours: Monday - Friday 8:30AM - 5:00PM

 

Reliant Medical Group is seeking a Clinical Quality Manager that would be responsible for the reporting of clinical quality data including project design, data collection, analysis and report creation. Provides clinical, technical support and data collation for the Patient Care Assessment (PCA) program of the organization, including the Medical Staff departments and clinical areas.  Assists and supports the organization’s departments and committees with the design, implementation and reporting of focused studies pertaining to particular performance improvement activities.  Responsible for maintaining clinical quality databases and general reporting to administration and to the clinical practice committee.

Responsibilities

  • Provides support to the organization’s Patient Care Assessment Program, Clinical Practice Committee, and Quality Design Teams including, but not limited to, the following activities assisting with the scheduling and coordination of committee meetings, preparation of meeting agendas, appropriate documentation to the committees, including correspondence and follow up to issues related to the purpose of the committee. Responsible for the preparation and the development of the annual work plan for the Quality Management/Performance Improvement Program for the organization.

 

  • Performs case reviews on medical records to identify quality of care or substandard care issues referred from risk management, incident reports, audits, sentinel events, clinician referrals or any complaints related to quality of care. Case reviews are conducted collaboratively with the Quality Management departments of the major payers, or part of the organization’s Peer Review Program.  Reviews will be viewed as confidential information under the organization’s Peer Review policy and the Commonwealth of Massachusetts General Laws, which confirm the protected and confidential nature of all peer review activities.

 

  • Develops measurable indicators of quality for quality projects. Works with data analysts to collect administrative data.  Performs the analysis and reporting of clinical quality projects, including compliance to clinical practice guidelines, including standards of national accrediting agencies for ambulatory care.

 

  • Participates in the selection of the organization Specialty Physicians and Primary Care practitioners’ quality measurements, working collaboratively with the Department Chairs and Division Directors of the departments and participates in the chart reviews as needed.

 

  • Conducts the Medical Staff department’s annual review of quality measures within the timeframe designated to provide physician feedback to be used in the physician’s performance evaluation for aggregate level and physician specific rates.

 

  • Monitors the quality of care and service delivered at the various locations of the multi-specialty group practice, including the patient satisfaction results and trending of complaints related to quality.

 

  • Participates with the development, implementation and coordination of policies, procedures and protocols that ensure compliance with legal and other external regulations/requirements to support the continuous performance improvement of the quality of care and service provided by the organization.

 

  • Works collaboratively with major payers’ Quality Management Departments on clinical and service quality improvement activities.

 

  • Adheres to the organization’s policy on Confidentiality and HIPPA regulations, which protects the privacy of member information and records. Responsible for protection of information and documentation related to the peer review process, which prohibits the release of any identifiable medical information or inappropriate disclosure of such information.

 

  • Coordinates the activities of the department to ensure effective dovetailing of efforts with the other nurse analyst(s) and with the other members of the OMD team, including the data analysts, case managers, and division of drug management services.

 

  • Represents the quality nurse analysts at appropriate committee meetings, including the Clinical Practice Committee and the Risk Management Committee, and other meetings as needed. Creates and files minutes for the Clinical Practice Committee.

Qualifications

Bachelor’s Degree in Nursing with a current Massachusetts nursing license and five years related experience in healthcare setting including hospital medical/surgical or ambulatory care. Quality management/performance improvement experience preferred.  PC based experience in database management, statistical analysis and graphics software desirable.  Microsoft Office including PowerPoint and Access experience preferred.   Excellent interpersonal, communication and organizational skills.

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