Registered Nurse (RN) - Quality Coordinator Population Health
advocate Health Care
Preferred candidate will have 5 years in quality improvement experience in a healthcare environment.
Major Responsibilities:
Coordinates, facilitates and implements best practices strategies for assigned patient populations to meet accreditation, quality and cost goals. Provides quality assurance on all aspects of implementation of Population Health Services in conjunction with external and internal implementation representatives.Collaborates with the management team to develop and maintain an ongoing quality management program for Population Health Services in accordance with regulatory requirements and client contractual agreements.Responsible for the development and implementation of indictors of operating thresholds for quality and productivity, development and delivery of management reports, development and implementation of corrective action or quality improvement plans and ensures appropriate dispute resolution procedures are in place.Conducts focused accreditation audits of cases completed by the Aurora Population Health Services team and provides feedback to audit staff. Provides statistical reports to manager regarding results of audits.Understands and interprets multiple contracts and contractual obligations in order to enable the Population Health Services team to achieve maximum quality, clinical and financial outcomes.Participates in the development of Population Health Services policies and procedures. Communicates the value of the Aurora Accountable Care Network and Aurora's integrated delivery system.Maintains current knowledge of contracts, applicable departments/organizational policies, procedures, provider listings and NCQA standards. Independently seeks and gains knowledge of organizational and industry issues and changes as they pertain to this role.Establishes and maintains relationships with external partners (employer, sales team, payers/third party administrators, etc.) and internal partners to improve the overall quality and efficiency of care provided to health plan members. Collaborates with nursing and/or patient education, physicians, providers and staff to review, design, and coordinate the use of patient education materials.Plans, implements and evaluates educational opportunities based on identified needs assessment and requests, results of activities, new technology, healthcare trends, regulatory agency requirements, strategic planning, patient populations, scopes of service, and care management priorities. Ensures consistency, quality, and evaluates educational programs for staff and patients ensuring quality and cost effectiveness.Drives development of improved Electronic Health Record tools to support Population Health Services in collaboration with key functional departments and leadership.
Licensure, Registration, and/or Certification Required:
Education Required:
Experience Required:
Knowledge, Skills & Abilities Required:
Physical Requirements and Working Conditions:
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
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