ChristianaCare is looking for a Clinical Quality Specialist who will partner with caregivers, leaders and payers ensures effective implementation of strategies to support value-based contracts and regulatory requirements are met or exceeded.
Quality Specialist will be responsible for :
Maintains knowledge value-based contracts serving as a Subject Matter Expert (SME).
Assesses appropriate inclusion/exclusion of data based on defined data dictionary; assists in evaluation of data dictionaries and utilizes data specification and code to validate information being placed in new applications related to quality.
Establishes and performs quality control checks for assigned databases.
Analyzes data and make targeted recommendations on areas of focus for established benchmarks in the evaluation of effectiveness and impact and assist in developing strategies to improve performance.
Educates staff about quality, cost and utilization metrics and specifics relating to their practice with innovative ways for performance improvement.
Establishes a systematic approach to all aspects of the project/program to include assessment and readiness, planning, training, implementation, coaching and sustainment.
Recommends resources to support the project and organizational, and/or clinical service line needs.
Evaluates and maintains clear documentation of project achievements based on established goals.
Assists in the identification of issues with data collection methods; assures methods for collection meet/exceed accreditation, regulatory, and institutional standards.
Presents progress reports/findings on a regular basis to appropriate constituencies.
Generates routine and ad hoc reports as directed within required time frame.
Maintains competency in EHR platforms, registries, and other applications specific to duties.
Advances knowledge of current computer software and demonstrates ability to learn and utilize new technology and/or software applications and assimilate them into daily work routine.
Attains and maintains proficiency in data abstraction and entry.
Utilizes basic understanding of ICD-10 and CPT coding.
Maintains a collaborative professional working relationship with peers, supervisors, clinicians, administrative staff, and external partners.
Maintains confidentiality of patient/members and staff information; compliant with HIPPA regulations.
Maintains required credentials; assume responsibility for ongoing professional growth.
Actively participates in system wide management activities, attends meetings and in-service/educational programs, and other activities as requested.
Perform assigned work safely, adhering to established departmental safety rules and practices; reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.
Performs assignments that need to be completed, even when outside the scope of routine responsibilities; adaptable to changing departmental conditions.
Bachelor's degree in healthcare or related business field.
At least five years of work experience with at least two years in patient safety, quality or performance improvement
Organizational skills and project management required.
Knowledge of/or experience in any of the following is preferred: Outcome analysis, utilization management, clinical experiences in patient care processes, medical records, performance improvement, team facilitation and education (patient/staff) and physiology and disease processes.
Strong Excel skills preferred.
Knowledge of medical terminology and anatomy required.
Internal Number: JR55397
About ChristianaCare Health System
ChristianaCare Health System is headquartered in Wilmington, Delaware and is one of the country's largest health care providers, ranking 21st in the nation for hospital admissions. Christiana Care is proudly a Nurse Magnet recognized institution. Christiana Care Health System is also one of the largest health care providers in the mid-Atlantic region, serving all of Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland and New Jersey. A not-for-profit, non-sectarian health system, Christiana Care includes two hospitals with more than 1,100 patient beds, and is a major teaching hospital with two campuses. Christiana Care is continually recognized for excellence on a regional and national level. Our role in the community is expressed in the Christiana Care Way: "We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value."Christiana Care is a great place to work because we value diversity and recognize it to be a core part of our success. Because of the diversity of our employees, affiliated health professionals and volunteers, we are ...positioned to meet the unique needs of our patients and community. We acknowledge and celebrate the uniqueness and talent of each employee. Because of our talented workforce we are able to provide a quality healthcare experience to our patients and community. We strive to create an inclusive environment in which individual diversity can be leveraged and thrive. Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.