Clinical Quality Improvement (QI) Lead, HYBRID at Children’s National Hospital

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Full Time

Start Date

Immediate

Expiry Date

24 Feb, 26

Salary

0.0

Posted On

26 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Quality Improvement, Quality Assurance, Project Management, Data Analysis, NCQA Compliance, HEDIS, Medicaid Compliance, Communication Skills, Organizational Skills, Team Collaboration, Root Cause Analysis, Training Facilitation, Statistical Analysis, Performance Improvement, Educational Interventions, Continuous Quality Improvement

Industry

Biotechnology Research

Description

The Clinical Quality Improvement (QI) Lead in collaboration with HSCSN Quality Assurance leadership leads the development, planning, and implementation of QI initiatives to ensure the delivery of quality health care and services. The QI lead will also support quality oversight, assessment, and NCQA compliance initiatives. She/he will be a subject-matter expert in quality improvement and quality assurance and will be responsible for working with internal and external stakeholders. Minimum Education Bachelor's Degree Ideal candidate should hold bachelor’s degree with public health background or other health related academic credentials and clinical background (RN, LPN, social worker etc.) (Required) Master's Degree in MSN, MPA, or MPH. (Preferred) Minimum Work Experience 2 years of experience in developing, implementing, and evaluating clinical QI/PI initiatives, NCQA Accreditation, and HEDIS in a MCO (Required) 2 years of professional clinical experience. (Preferred) Required Skills/Knowledge Ability to work under pressure independently, strong organizational and analytical (qualitative/quantitative analysis) skills is required. Experienced in facilitating and coordinating various QI workgroups including HEDIS trend analysis, developing and implementing various initiatives. Demonstrated project management skills with the ability to handle multiple concurrent projects. Ability to work effectively with providers and multidisciplinary teams across departments. Experience in NCQA accreditation readiness activities (managing accreditation project plan, supporting team in reviewing/writing NCQA compliant analysis, preparing materials for survey etc). Experience with Medicaid regulatory compliance and external quality review organization (EQRO) activities such as managing Performance Improvement Projects (PIPs) Excellent written and verbal communication skills. Must be able to understand and use CQI principles/tools (institute for Health Care Improvement's Model for Improvement). Knowledge of computer applications MS Suite (Word, Excel, PowerPoint, Adobe Pro, Outlook). Required Licenses and Certifications Registered Nurse Licensed as a Registered Nurse (RN) (Preferred) CPHQ preferred (Preferred) Job Functions Essential job duties: Participates and coordinates quality improvement performance measures including but not limited to: Analysis (Quantitative and Qualitative) Performs root cause analysis to assess low performance on chosen indicators, sets SMART aims with appropriate stakeholders and identifies key drivers for success. Identification of opportunities for improvement on internal quality outcome measures (KPI, HEDIS, CAHPS etc.) and collaborate with various teams to design, implement, and proactively monitor outcomes. Maintains expertise in continuous quality improvement principles and concepts. Design methodology, collect and interpret data, conduct clinical and statistical analyses, and monitor outcomes. Acts as a project leader by overseeing, coordinating, monitoring, and reporting on assigned projects and quality workgroup. Prepares detailed project plans including work plans, resources requirement, timeframes, and methodology to achieve project objectives. Reviews project status at each phase, identifies variances from approved timetables, and proposes modified time frames. Collects, analyzes, and acts upon quality outcomes data, with respect to members and providers to effectively manage care including measurement of specific procedures, and the development, implementation, and evaluation of interventions. Analyzes member/provider survey data and identify opportunities to improve results Participates and lead discussions, facilitate trainings related to QI tools and NCQA accreditation Support HEDIS inventions/initiatives. Partners with Business Analysts, Business Informatics specialists, and other available resources (i.e. consultants) to develop needed reports to assess outcome and process measures needed for improvement work. Develop targeted/general member and provider educational interventions to support and improve specific QI initiatives, working in collaboration with internal and external stakeholders Tracks and monitors quality of care/services issues regarding members and/or providers. Participate and support the HSCSN Quality Management Committees and sub-committees Other job duties: May perform other duties in addition to those outlined in this job description. Organizational Accountabilities Organizational Accountabilities (Staff) Employee Excellence Demonstrates understanding of quality of service and collaborates with co-workers to ensure excellence standard is achieved Innovates through improvement of care and/or efficiency of operational processes. Dedicated to a standard of performance excellence and high quality All In Embraces changes/improvements and actively participates in the implementation of new/improved programs, technology, new equipment, systems and resources that promote quality of care, safety and efficiency Identifies, prioritizes and selects alternative solutions to determine best outcome Action Oriented Maintains a high level of activity/productivity, meeting deadlines and appropriately prioritizing tasks to meet business demands Anticipates problems and attempts to solve before they develop Supervisory Responsibilities None Blood Borne Pathogen Exposure Category III: Job does not involve exposure to blood, body fluids, non-intact skin or tissue specimens. Incumbent does not perform or help in emergency medical care or first aid as a part of his/her job. Protected Health Information Access Level Level IV - Full Access Incumbents in this job may access any protected health information associated to a customer's needs, the service(s) rendered and the position's functions. Working Environment This job operates in a hospital or office environment. Physical Requirements Light Work: Lifting 25 lbs. maximum with frequent lifting and/or carrying of objects weighing up to 10 lbs. Travel Requirements DC Residents Encouraged to Apply

Responsibilities

The Clinical Quality Improvement Lead will develop, plan, and implement quality improvement initiatives to ensure quality healthcare delivery. They will also support quality oversight and NCQA compliance initiatives while collaborating with various stakeholders.