RN Clinical Quality Analyst - Documentation Review
Location:
Frisco , Texas
Posted:
February 03, 2017
Reference:
00001HN3
POSITION SUMMARY:


Under the general direction of the Senior Nurse Manager, the RN Clinical Quality Analyst is responsible for conducting call monitoring and case file reviews for phone and non-phone transactions at the clinical and business level. The RN Clinical Quality Analyst will identify opportunities to improve the Customer Experience and drive clinical best practice.

PRIMARY DUTIES AND RESPONSIBILITIES:
  • Reports directly to the Senior Nurse Manager
  • Ensures team is meeting contractual obligations
  • Conducts call monitoring and case file reviews utilizing the phone and non-phone business level quality transaction methodology, and sampling along with clinical considerations
  • Responsible for entering all call monitoring data into the quality tool on a daily basis, in order to determine causes of quality issues and to solve them
  • Reviews, analyzes, and reports on quality discrepancies as reported through the call monitoring Makes recommendations for corrective and preventative actions as variation and performance gaps
  • Provides immediate feedback to the Nurse Manager that requires performance or corrective action per the quality review process, and adherence to all policies and procedures of the program and organization
  • Leads and participates in call calibrations to ensure credibility of the quality monitoring scoring process
  • Participates in trending activities that support the establishment of quality metrics, and continual process improvements across the organization
  • Responsible for utilizing all technology and resources effectively and efficiently
  • Recommends and creates training opportunities to improve clinical best practice
  • Provides management with daily, weekly, and month end quality results
  • Implements and ensures that processes are in place to monitor quality and program compliance; is accountable for program quality and compliance with standard operating procedures
  • Coaches, counsels nurse to help drive clinical best practices
  • Provides call monitoring training /calibration for associates
  • Provides feedback up and down the organization (positive and constructive)
  • Participates in client meetings; prepares agenda and/or takes meeting notes
  • Translates and oversees organizational strategies for assigned goals; analyzes progress of tactical issues
  • Identifies client issues; receives and triages client requests
  • Proactively identifies program issues and proposes ways in which to address their concerns
  • Maintains positive rapport with clients
  • Performs related duties as assigned



Qualifications:
EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
  • Active Registered Nurse (RN) license and possess the ability to be licensed as a Registered nurse in multiple states. All nursing licenses must be free of disciplinary actions and/or restrictions.
  • Quality and/or process improvement experience preferred
  • Clinical experience 5 years
  • Call Center/tele-health experience preferred
  • Graduation from an accredited program
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
  • Excellent oral and written communication skills
  • Excellent analytical and organizational skills; attention to detail
  • Excellent interpersonal skills
  • Ability to work independently
  • Ability to use a computer for data collection
  • Ability to manage multiple tasks along a parallel process
  • Evidence of continuing education a plus
  • Must have proficiency in Microsoft Word, Excel, and knowledge of Microsoft SharePoint a plus

A little about us:
Where knowledge, reach and partnership shape healthcare delivery.

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