Job Description

Location: Corporate
Posted Date: 3/9/2020
Position Summary:
The System Quality Measures Resource Specialist will manage the day to day operations for all hospital quality measures reported to external agencies including but not limited to Medicaid, Medicare, and The Joint Commission.
Key Responsibilities:
  • Act as the resident expert for the system on all quality measure specifications and expectations;
  • Provide comprehensive clinical review of every core measure outlier identified by data abstractors with confirmation of outlier;
  • Create outlier reports for hospital stakeholders that identify root cause and other data elements used for trending;
  • Monitor all submissions for quality measures to external agencies and reconcile transmission errors as applicable;
  • Partner with Hospital Quality Department to complete additional reporting requirements to external agencies;
  • Complete data abstraction for web-based, annual measures and other measures as identified by the Director, Clinical Performance Analytics;
  • Facilitate validation activities as directed by external agencies for on quality measures;
  • Monitor timeliness of data abstraction and work with abstractors to adhere to strict internal reporting schedule;
  • Establish and maintain positive working relationships with internal customers and external vendors, including individuals who are supervised by others.
  • Provide leadership to other members of the team, including training of individuals on how to interpret quality measure specifications and core measure expectations;
  • Organize and distribute all key reports produced by external agencies on hospital quality metrics as directed by the Quality Resource Manager;
  • Assist with other quality activities as directed by the Director, Clinical Quality Analytics
Required Knowledge & Skills:
  • Ability to interpret clinical information and perform objective review of medical record
  • Extensive knowledge of quality measure specifications and expectations
  • Ability to maintain high level of expertise on quality measures with periodic updates and new measures
  • Ability to quickly assimilate knowledge of processes and systems to develop and deliver necessary education/ training to departmental staff and internal customers
  • Ability to work in a fast paced environment, meeting deadlines yet being flexible to shift focus as needed
  • Ability to present ideas and information concisely, in a visually appealing, and statistically meaningful way to varied audiences
  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
  • Ability to establish and maintain positive and effective work and team relationships with coworkers, clients, members, providers and customers in a deadline drive, multi-tasked environment
  • Demonstrated ability to function independently, manage multiple projects, and meet deadlines
  • Excellent verbal and written communication skills, excellent problem solver
  • Proficiency in and presenting information, including expertise with MS Excel, MS PowerPoint
I. Education: BSN preferred
II. Experience: Health Care Data Indsutry experience required. 5 years of core measure data abstraction required. 1-3 years of coordinating operations of publically reported data.
III. Certification/Licensure: Registered Nurse
IV. Software/Hardware: High proficiency with Microsoft Office software, especially Microsoft Excel, Powerpoint.

Application Instructions

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