Quality Improvement/Quality Assurance RN
The Quality Improvement/Quality Assurance-RN ensures all Behavioral Health (BH) processes are controlled and monitored for quality and compliance in collaboration with the BH, Compliance, Operations, and Training departments. This position is responsible for implementing quality assurance and quality improvement initiatives to meet state and federal requirements.
Every Adelante employee will strive to maximize their performance and contribution to Adelante Healthcare and the community we serve every day. Employees are expected to work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation, and the highest standards of personal integrity, professionalism, and competence.
OUR CORE VALUES
ESSENTIAL SKILLS AND EXPERIENCE
- Bachelors degree in Nursing
- Minimum five (5) years of healthcare experience, which includes two years in behavioral health leadership experience
- Experience in Patient-Centered Medical Home (PCMH) practices is preferred
- Ability to meet and communicate effectively with staff, patients, community representatives, Adelante Healthcare leadership, and business partners
- Ability to solve problems using a logical, systematic, and tactical approach
- Ability to help others to increase their knowledge, skills, and abilities to enable them to perform at a higher level
- Ability to manage projects that are data and deadline-driven
- Ability to provide effective performance and results management
- Ability to critically analyze safety situations and respond accordingly
- Ability to maintain confidentiality, privacy, and security of protected information
- Ability to draft analytic reports by integrating multiple data elements and perspectives
- Ability to manage partnerships, and promote teamwork within a work unit and across departmental/organizational lines
- Knowledge of SBAR, CQI, RCA, ACA, and PDSA methodology
- Ability to manage time efficiently and productively
- Excellent working knowledge of Microsoft Office Applications including Outlook, Word, Excel, Teams, and SharePoint
- Experience working with NextGen or other electronic health record systems; knowledge in navigating the system for data entry and chart auditing
- Knowledge of regulatory agency requirements including Joint Commission, HRSA, and AZDHS
- Must have reliable transportation that can meet any operational reassignments of the organization during the workday. If the employee is driving during work hours, the employee is required to possess a valid drivers license and must be in compliance with Arizona vehicle insurance requirements.
- Ability to travel to health centers as needed
- Certification to perform cardiopulmonary Resuscitation (CPR) for the Health Care Professional and use of an AED through courses that follow the guidelines from the American Heart Association and Red Cross (cognitive and skills evaluations)
- Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations
NONESSENTIAL SKILLS AND EXPERIENCE
- Fluency in a language in addition to English a plus (Spanish preferred)
The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job-related selection or promotional criteria.
- Implement the Quality Management Plan BH goals
- Collaborate with BH programs to develop action plans to improve Unified Data System (UDS) and The Healthcare Effectiveness Data and Information Set (HEDIS) measures
- Lead BH CQI across AHC
- Conduct BH Process evaluations
- Provide QI and QA education sessions
- Assist QIM with HEDIS CQIs
- Works independently under the guidance of the Quality Improvement Manager
- Create analytic reports and present data at weekly, monthly, and quarterly meetings
- Complete NAHQ introductory course within first 3 months of employment
- Stay current with regulatory agency requirements and provide education and updates to BH team on current regulatory requirements and changes
- Other projects as requested by Quality Improvement Manager
- Conduct BH Chart reviews monthly
- Create, review, and revise tracers using the electronic system
- Develop, organize, schedule, and lead all tracers for the Behavioral team
- Review tracer findings with the Behavioral Team, Quality Improvement Manager, Quality Assurance Manager, and Clinical Risk and Safety manager to provide guidance on solutions to deficiencies
- Develop and monitor action plans for a compliance rate of <90%
- Develop and monitor CQIs for a compliance rate of <80%
- Provide assistance in revising policies and procedures
- Assist with Quality-of-Care Concern
All employees are responsible for promoting and participating in interdisciplinary communication and collaboration to enhance the delivery of quality across the healthcare system. Employees should maintain an environment that supports and engages patients and co-workers in a caring team-based model to promote wellness and improve health outcomes.
ADHERENCE TO COMPLIANCE AND CODE OF CONDUCT
All employees are required to comply with Adelante Healthcares written standards, including its Compliance Program and Standards of Conduct, policies and procedures, and reporting of any conduct that potentially violates Adelantes legal or compliance requirements. Such compliance will be considered as part of the regular performance evaluation.
PHYSICAL DEMANDS AND WORK ENVIRONMENT
The physical demands and work environment characteristics described here represent those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Physical demands: While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools, or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions. The employee must frequently lift and/or move up to 25 pounds without assistance and may occasionally be required to lift or move up to 50 pounds with assistance. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
Work environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time when traveling to various clinic sites. The noise level in the work environment is usually moderate. The employee may be subject to health hazards (contagious diseases, bloodborne pathogens, etc.) when working in the clinic area.
In any organization or job, changes take place over time. Although an effort will be made to keep the job-related information current, this is not an all-inclusive list of job responsibilities. Adelante Healthcare, Inc. reserves the right to revise or change job duties and responsibilities as the business need arises. In compliance with EEOC 29 CFR part 1630, if the essential functions of this position cannot be performed in a satisfactory manner by the employee, further accommodations shall be provided if it does not constitute undue hardships upon this organization.