Registered Nurse (RN) - Quality Assurance
CommuniCare
San Antonio, TX

Quality Assurance Registered Nurse (QI2606 - NIC)

Provide support to the Director of Quality in the planning and implementation of a systematic program for outcomes management and quality improvement efforts at the Center. In conjunction with the Quality team this position is responsible for ensuring compliance with internal as well as external regulatory reporting requirements. Review applicable employee immunization records and maintain OSHA exposure files. Works closely with clinical staff in the optimization of workflows for primary care practices as they make the transition to value-based, population health payment models. The goal is to help providers measurably improve quality scores through improved training, workflows in offices, and data capture. DUTIES AND RESPONSIBILITIES: 1. Works in a collaborative manner with providers, administrators, department managers and others to identify and meet the continuous performance improvement requirements of the organization. Demonstrates performance improvement in the following areas as appropriate: clinical care outcomes, customer/service improvement, operational system/process, and safety. 2. Performs research, collects and/or analyzes data reports, and implements processes to achieve improved performance. Work with Director of Quality to prepare and present summary reports and trend analyses of program activities to the QA/PI committee on a regularly scheduled basis, using data obtained from sources such as internal PI/RM reports, staff and employee surveys, incident and variance reports and screens, self-inspection programs and internal & external on site audits for compliance. 3. Is responsible for Pay for Performance and Accountable Care Organization-related functions to include clinical outcome metrics review, personal health assessment, collaborating with Population Health Team and Value Based health initiatives, including hospitals for timely notification of ER visits, hospital admissions, and discharges, collaborating with sub-acute facilities for beneficiary admission, status, and discharge planning, and any other administrative activities related to the overall clinical care improvement of members. 4. Facilitates/leads organizational improvement activities utilizing the PDSA improvement methodology. Recommends tools and assists teams throughout the improvement process. Conduct concurrent reviews of the literature and websites to provide teams and service lines with up-to-date evidence and best practice recommendations. 5. Organizes and facilitates meetings and special events for the Quality Management Department; schedules and coordinates dates and times, venues, attendance, agendas, and facilities; takes minutes, and provides administrative support and follow-up on matters arising from meetings. 6. Provides excellent internal/external customer service via telephone, fax or face-to-face contact to assist patients with their health care needs. 7. Maintain ongoing professional growth and development. 8. Maintains privacy and confidentiality with regard to all patient, staff and agency information. 9. Actively participate in QA/PI team orientated decision-making process. Is a team player, willing to be flexible and open to other's ideas. 10. Work cohesively with Human Resources to review and validate questionable employee immunizations. Track and monitor employees' HEP B series and employee flu shots for completion. 11. Monitor incident reports for exposures. Maintain OSHA exposure files and follow up on required exposure testing protocol. 12. Performs other related duties as assigned. JOB QUALIFICATIONS: Associate's degree in nursing required Bachelor's degree from an accredited school of Nursing preferred Licensed as a Registered Nurse in the state of Texas Knowledge of community resources, works with diverse groups, and maintains cohesive relationships with healthcare providers, site managers and outside organizations Knowledge of immunization regulations required Minimum three (3) years' experience as an RN required Minimum three (3) years' experience in Quality Assurance in health care settings required Must achieve Quality Improvement certification within two (2) years of accepting the position, if not already obtained Bilingual in English and Spanish required Computer literacy with extensive knowledge of spreadsheets and graphs Must have reliable transportation to perform clinical site audits within Bexar, Kendall and Hays counties and additional counties due to continued growth Certified in Basic Life Support (BLS), Instructor-led by the American Heart Association Scheduled hours and/or work locations are subject to change REQUIRED PHYSICAL AND MENTAL ACTIVITIES AND REQUIREMENTS: Finger Dexterity: Using fingers to make small movements such as typing or picking up small objects. Normal fine and gross motor control of fingers and hands. Talking: Frequently conveying detailed or important instructions or ideas accurately, clearly, or quickly. Hearing: Able to hear average or normal conversations and receive ordinary information; hear whispered voices at five (5) feet. Repetitive Motions: Frequently and regularly using the wrists, hands, and fingers. Visual: Visual acuity is necessary for the proper evaluation of a patient and to prepare or inspect documents or other materials. Ability to accurately view computer monitors Physical: Sitting 20-30% of time and standing, walking 70-80% of time. Lift up to 25 lbs.; push and pull up to 45 lbs. Able to bend at the waist, twist and turn along axial plane.