Job Description

Quality Improvement Nurse

The Quality Improvement Nurse provides clinical leadership to enhance patient care and safety by monitoring healthcare processes, auditing clinical data, and implementing evidence-based improvements. This role focuses on improving clinical workflows, ensuring compliance with regulatory standards, and closing care gaps for patients within the community.

Program Specific Essential Duties and Responsibilities:

• Data Analysis & Auditing: Review patient charts, audit clinical records, and review quality metrics to detect care delivery issues and compliance gaps using standardized criteria (e.g., HEDIS, UDS, CMS, ACO metrics). Abstract data to support quality metric performance for UDS, ACO, and managed care plans. Develop and implement quarterly provider peer reviews. Develop and implement non-provider clinical support staff quality and risk management audits. Maintain indicator and peer review/audit databases. Produce reports and graphs of indicator scores and peer review/audit results.
• QI Project Management: Design and implement quality improvement projects (e.g., PI plans, PDSA cycles) aimed at improving clinical outcomes and reducing error rates.
• Clinical Compliance: Monitor adherence to regulatory standards and update clinical policies/procedures and clinical guidelines accordingly.
• Staff Training & Education: Train staff on new care protocols, evidence-based practices, and documentation improvements.
• Performance Metrics Tracking: Collect, analyze, and report on key performance indicators (KPIs) to leadership regarding health center goals.
• Risk Management: Conduct investigations and root cause analyses of patient incidents or near-misses, preparing detailed reports for the risk management team.
• Collaborative Improvement: Work with interdisciplinary teams (physicians, nurses, IT, management) to develop solutions for workflow efficiency. Work collaboratively with Director of Quality to produce documents and tools for Quality Council and quality-related meetings, including taking meeting minutes for the Quality Council. Participates in Quality Council meetings and quality-related meetings.
• Any and all other duties as assigned

Qualifications and Education Requirements:

• One of the following combinations of education and employment experience must be met in order to be considered for the position:
• Education: Bachelor of Science in Nursing (BSN) preferred; Associate Degree in Nursing (ADN) with relevant experience accepted.
• Licensure: Valid Registered Nurse (RN) license in the state of practice.
• Current BLS/CPR certification required.
• Experience: Minimum 3 years of clinical nursing experience, with 2-3 years in a quality assurance or improvement role preferred.
• Certifications: CPHQ (Certified Professional in Healthcare Quality) is a plus.
• Skills: Proficiency with Electronic Medical Record (EMR) systems. Excellent computer skills (Microsoft Word, Excel, Powerpoint, and Outlook). Strong knowledge of QI methodologies (e.g., PDSA, Root Cause Analysis). Excellent analytical and data interpretation skills (Epic reporting bench experience is preferred). Effective verbal and written communication skills. Motivational Interviewing skills.

Reports to: Director of Quality

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