Clinical Quality Specialist

Service Line: Federal

Status: Exempt

OVERALL SHORT DESCRIPTION

Under general supervision, the Clinical Quality Specialist (CQS) serves as a member of the project team responsible for coordinating and implementing quality improvement (QI) activities with collaborators for specified projects as outlined by the Centers for Medicare & Medicaid Services (CMS). The CQS is assigned to a group of selected providers to facilitate their QI efforts in specific health-related topics. The CQS is the principal HSAG contact for providers and is responsible for coordinating, guiding, and advancing their QI activities throughout the project, as well as monitoring and reporting on all provider QI activities and HSAG Internal Quality Control (IQC) metrics. The CQS must be knowledgeable of and be able to use Quality Improvement Organization (QIO-) and CMS-directed QI tools and methods, including the identification and incorporation of other resources obtained from the Quality Improvement Organization Support Center (QIOSC), MedQIC, the Institute for Healthcare Improvement, and other recognized quality improvement sources.


ESSENTIAL FUNCTIONS

1. Serves as the lead HSAG contact to assigned collaborators and communicates/consults with them on a regular basis to assist with their interventions related to established goals, objectives, and measures, and provides technical assistance and recommendations as needed.
2. Assesses current collaborator processes, support systems, and barriers related to the QI focus. Based upon assessment findings and in collaboration with the project team, determines appropriate interventions and modifications and shares these with collaborators.
3. Able to communicate and work well on tasks with ancillary and ad hoc team members to plan, facilitate, and execute interventions.
4. Uses clinical expertise, problem-solving techniques, flow diagrams, statistical process control charts, cause-and-effect diagrams, force field analysis, root cause analysis, and other QI methods to demonstrate to collaborators how to reengineer existing processes or design new ones to improve performance and/or documentation on quality indicators, which are below standards.
5. Provides necessary QI education and materials and directs providers to resources that will assist them with understanding and using QI techniques.
6. Possesses the ability to discuss complex health care issues during face-to-face meetings, teleconferences, and through written correspondence with providers and stakeholders. Refers questions to appropriate HSAG staff members and the QIOSC as needed.
7. Remains current and knowledgeable about new QI activities, opportunities, tools, and techniques through training, education, and a variety of nationally recognized sources.
8. Routinely documents and reports project status, on-site visits, provider interventions, activities, and barriers/solutions using appropriate HSAG and/or CMS reporting tools and databases.

ACCOUNTABILITY

The CQS works under the general supervision of the project director. Accountable for the timeliness, completeness, accuracy, and quality of all assigned functions and tasks.

WORK CONDITIONS

In this position the employee will be subject to environmental conditions related to vehicular and possibly air travel to and from locations, which may include overnight stays. Additionally, the employee must also be willing to work in a cubicle office environment, use a computer, and attend meetings when not traveling.


PHYSICAL AND MENTAL DEMANDS/COMPETENCIES

1. Demonstrate an use problem-solving skills.
2. Communicate clearly and accurately.
3. Develop and deliver oral presentations to large audiences and speak at public gatherings.
4. Facilitate collaborative relationships with providers and stakeholders through verbal and written communication skills.
5. Explain the fundamentals of the Continuous Quality Improvement (CQI) process and assist providers in implementing CQI in their organizations.
6. Complete work assignments, accurately, timely, and independently with minimal supervision.
7. Travel to meetings and presentations in and out of state.
8. Use a computer and appropriate software programs.
9. Adhere to established company, state, and federal confidentiality policies.
10. Tolerate and accept opposing views.
11. Participate in and contribute to project team meetings.
12. Adapt to different situations and remain flexible in a fast-paced, changing environment.
13. Cope with stressful situations by maintaining high performance when confronted with pressures of internal and external deadlines and time limits.

QUALIFICATIONS

1. Candidate must be an experienced health care professional with a bachelor's degree in appropriate science or related discipline and hold a current Arizona RN license. CPHQ or equivalent combination of education and experience preferred.
2. Three or more years of health care experience in a hospital and/or skilled nursing facility.
3. Quality management experience and knowledge of QI tools and techniques.
4. Experience specific to surgical care, infection control, pressure ulcer reduction, and/or physical restraint management is preferred.
5. Possess a general understanding of the changing health care environment.
6. Proficient in Microsoft Office.
7. Proficient in oral and written communication and interpersonal skills.

DISCLAIMER

This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts, or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., changes in personnel, emergencies, workload, technological developments, or company priorities).
 

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