Kaiser Permanente Consultant (RN), Clinical Quality - Georgia in Atlanta, Georgia
Responsible for continuous quality reviews of the program to ensure HEDIS, STAR and other Ambulatory Clinical, Adult Medicine/Pediatric/Specialties/Acute & Urgent Care departmental quality measures are met. In partnership with TSPMG, Centers of Care Partnership and Medical Office leadership, the Clinical Quality Consultant Liaison develops, implements and maintains programs for quality monitoring and improvement. Responsible to maximize team performance by working collaboratively with team members from diverse backgrounds and with diverse capabilities. Evaluates the quality outcomes through a process improvement approach and ensures clinical documentation aligns with established workflows. Facilitates nursing engagement in quality outcome measures by partnering with the Workflow Consultants and Professional Development Specialist to ensure sustainable movement. Serves as an active member of all quality committee meetings, performing quality clinical record reviews, maintains up to date knowledge to HEDIS/STARS standard and facilitates formal training and corrective action.
Responsible to ensure all Ambulatory Clinical departments comply with HEDIS, STARS and quality metrics.
Services as the Operational Representative in Quality committee meetings and the Subject Matter Expert for the Ambulatory Clinical Department.
Participate in quality strategy and communicate recommendations that drive improved quality outcomes and proactive office metrics.
Functions as the quality liaison for Ambulatory Clinical Department Centers for Medicare and Medicaid (CMS) national quality indicators, HEDIS Quality Measures and Program Measures. Maintains up to date knowledge base related to National Quality indicator measures and reviews for new changes.
Provides Quality Improvement audits/reports that capture clinical care practices, quality outcomes and team/ individual performance.
Collaborates with physician and ancillary/medical office leaders to implement best practices, tools, processes and technology that supports quality target and outcomes.
Incorporates a variety of the health concepts, practices, and procedures to improve quality metrics.
Responsible for the education of clinical staff and Medical office leaders.
Performs quarterly quality meetings with staff.
Performs monthly audits of the team's compliance with improvement processes.
Ability to prioritize work and meet deadlines.
Ability to communicate effectively (verbally and written).
Responsible for submitting monthly report to Senior Directors for overall compliance with the program per Medical Office (Scorecard).
Responsible for delivering feedback in a timely manner that will assist operational leaders with their performance, management and action plans.
Analyze training needs, develops and administers instructional programs designed to optimize performance.
Minimum eight (8) years of clinical quality improvement or healthcare related experience.
Minimum five (5) years of clinical experience.
Bachelor's degree in health care administration, process improvement, clinical quality OR four (4) years of experience in a directly related field.
High School Diploma or General Education Development (GED) required.
License, Certification, Registration
Current licensure as a Registered Professional Nurse in the State of Georgia or able to obtain prior to date of hire.
Experience with care management programs for chronic conditions.
Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets.
Experience in electronic medical record documentation.
Experience in staff education with both nurses and physician audiences.
Knowledge of HEDIS specifications and methodology.
Knowledge of and experience with data collection and analysis.
Minimum ten (10) years of primary care nursing experience.
Master's degree in related field, healthcare, process improvement or clinical quality.
TITLE: Consultant (RN), Clinical Quality - Georgia
LOCATION: Atlanta, Georgia
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.