Quality Improvement Coordinator Resume Samples

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GS
G Stiedemann
Gwendolyn
Stiedemann
922 Gutmann View
Boston
MA
+1 (555) 917 4200
922 Gutmann View
Boston
MA
Phone
p +1 (555) 917 4200
Experience Experience
01/2014 present
New York, NY
Lead Quality Improvement Coordinator
New York, NY
Lead Quality Improvement Coordinator
01/2014 present
New York, NY
Lead Quality Improvement Coordinator
01/2014 present
  • Oversee and participate in validation activities to ensure that reported data are collected according to measurement methodology and meet the population, service and other indicator criteria; recommend improvements for accuracy, operational enhancements and policy changes, to support the most effective and efficient use of health care resources
  • In-depth knowledge of problem solving and technical writing; project management methodologies; data validation methods; and statistical and data analysis and research methods
  • Recommend quality improvement activities/strategies for implementation and leads or participates in work groups with Contractors and other stakeholders to implement approved activities/strategies
  • Proficient in medical record review/evaluation, analyzing and trending data, writing comprehensive reports, and presenting trends to large multi-disciplinary teams and or community stakeholders
  • Lead Agency efforts related to Quality Improvement Reporting, including the CMS 416, CARTS, MACPro, and quarterly/annual Waiver Update reports. Analyze, interpret and disseminate results of performance measures, PIPs and other studies to Division management and Agency leadership; ensure that results are publicly reported via the AHCCCS website and/or other means
  • Leadership & Training/Development: Provides leadership and training/development to project team members
  • Participates in clinical risk assessments and analysis and assists in the development of corrective action plans
12/2007 07/2013
Houston, TX
Performance & Quality Improvement Coordinator
Houston, TX
Performance & Quality Improvement Coordinator
12/2007 07/2013
Houston, TX
Performance & Quality Improvement Coordinator
12/2007 07/2013
  • Focuses organizational efforts on the improvement of clinical quality performance measures
  • Identifies population-based member barriers to care and works with the QMP team to identify local-level strategies to overcome barriers and close clinical gaps in care
  • Uses data to develop intervention strategies to improve outcomes
  • Supports quality improvement program studies with work that ranges from accessing and analyzing provider records, maintaining databases, and researching to identify members’ encounter history
  • Designs practice-level quality transformation through targeted clinical education and approved materials related to HEDIS / state-specific quality measures for provider and staff education during field visits
  • Engages providers in strategies to improve outcomes through collaborative partnerships
  • Develops and implements PIPs internally and across MCOs
04/2004 08/2007
New York, NY
Quality Improvement Coordinator
New York, NY
Quality Improvement Coordinator
04/2004 08/2007
New York, NY
Quality Improvement Coordinator
04/2004 08/2007
  • Identify trends and share results with ASO network providers
  • Assist with coordination of quality improvement activities
  • Actively participates or leads Performance Improvement Teams
  • Work with Organizational Leadership to create policies and programs
  • Assist with the process of data collection and the analysis of data related to Quality Improvement Activities
  • Assist with the monitoring of compliance with quality assessment and improvement
  • Incorporate results of annual member and provider surveys into provider follow-up and training
Education Education
Bachelor’s Degree in Nursing Preferred
Bachelor’s Degree in Nursing Preferred
Colorado State University
Bachelor’s Degree in Nursing Preferred
Skills Skills
  • Excellent relationship skills to include tact and diplomacy with an ability to work effectively with all personnel levels within the organization, including surgeons and physicians
  • Excellent written and verbal communication skills, includes public speaking
  • Experience with data extraction, reporting and analysis tools
  • Strong project management skills
  • Vision to take an idea and implement into a project, a report, a presentation, etc
  • 2+ years of experience in Medical Office, HMOm or Hospital Environment performing Administrative
  • Computer savvy
  • Microsoft Office/Suite proficient (Access, Excel, Outlook, PowerPoint, Word, etc.)
  • Great interpersonal skills
  • Excellent communication skills (written and verbal)
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1

Quality Improvement Coordinator Resume Examples & Samples

  • Knowledge of quality improvement and performance improvement principles and demonstrated practices there of
  • Demonstrated knowledge and experience with medical staff committee support and peer review processes
  • Knowledge of current public reporting requirements and indicators and metrics there of
  • Knowledge of current regulatory requirements including but not limited to standards of the Joint Commission, the CMS Hospital Conditions for Participation, and Title 22 licensing requirements
  • Understanding of audit/study methodology, healthcare statistics, and automated data information system as applicable to hospital and medical staff activities
  • Demonstrated clinical expertise in facilitating the evaluation of process improvement
  • Demonstrated advanced skills in data management and the ability to collect, analyze, and present data to groups and individuals
  • Demonstrated project management knowledge and skills
  • Ability to work collaboratively with physicians, hospital staff, and external organizations
  • Minimum three to five years clinical experience in related health care field
  • Minimum two years experience in healthcare quality assessment and improvement, including hands-on experience with supporting clinical department quality improvement committee structures and processes
2

Performance & Quality Improvement Coordinator Resume Examples & Samples

  • Current CPHQ or CHCQM certification Experience and education in data and outcomes measurement
  • 5+ years healthcare experience, or other relevant experience
  • 2+ years of quality improvement experience
  • Experience working in Medicaid
  • Access to reliable transportation to travel 50% within the state
  • Experience with Word, Excel, Power Point, Outlook, and Internet
  • Knowledge of one or more of: clinical standards of care, preventive health standards, NCQA, governing and regulatory agency requirements and the managed care industry
  • Masters degree
  • Six Sigma prepared
3

RN Quality Improvement Coordinator Resume Examples & Samples

  • Excellence: Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality / safety / service
  • RN, with state license to practice required
  • Associates degree required. Bachelor’s degree in nursing preferred, but will consider bachelor’s degree in other healthcare related field (ie: healthcare administration, business administration)
  • Working knowledge of National Quality Forum (NQF), Agency for Healthcare Research and Quality (AHRQ), Institutes for Healthcare Improvement (IHI) safety indicators, serious reporting events, safe medical practices, and Centers for Medicare and Medicaid Services (CMS) quality measures helpful
  • Minimum of 3 years relevant clinical and quality work experience in a healthcare setting
  • Knowledge of regulatory and accrediting standards preferred
  • Strong project management skills a plus
  • Knowledge of regulatory and accrediting standards and Medical Staff Office preferred
  • Patient safety experience and work with High Reliability Organizations / Systems a plus
  • Clinical knowledge and expertise in a clinical service line specialty is preferred
4

Rn-quality Improvement Coordinator Days CHI Health Nebraska Heart Resume Examples & Samples

  • Collaborates with the Director Quality and Safety and key ministry stakeholders to coordinate the reporting measures managed by the Quality Department
  • Reviews medical records and collects data for clinical care review and other quality improvement activities
  • Assists in organizing teams and responsible for tracking change processes facilitated by those teams. May facilitate select teams to assure timely assessment and implementation of process changes. May perform /support Root Cause Analysis efforts
  • Supports quality by monitoring various outcomes and quality improvement projects and works with other departments to develop processes to improve and sustain outcomes
  • Works with related software applications to identify opportunities for improvement and act on clinical data to achieve improved performance rates, evaluates, analyzes, tracks, and trends and displays data from related activities
  • Supports Quality Department goals by analyzing, interpreting and reporting data
  • Presents, educates and encourages the use of quality data/processes to improve safety and care delivery
  • Supports the Quality Department by inputting data measurements, monitoring various outcomes and quality improvement projects. Reports data through effective use of computer software programs
5

Rn-quality Improvement Coordinator Resume Examples & Samples

  • Bachelor’s degree required, bachelor’s degree in nursing preferred, will consider bachelor’s degree in other healthcare related field (ie: healthcare administration, business administration)
  • Will consider candidate that has an associate’s degree in nursing and is currently in a bachelor’s degree program or is willing to enroll and obtain a bachelor’s degree within three years from date of hire
  • Nationally recognized quality-related certification (ie: CPHQ, PMP, CJCP, CPPS) preferred
  • Experience in quality improvement principles, performance improvement methodology, project management and change management preferred
6

Performance & Quality Improvement Coordinator Resume Examples & Samples

  • Focuses organizational efforts on the improvement of clinical quality performance measures
  • Identifies population-based member barriers to care and works with the QMP team to identify local-level strategies to overcome barriers and close clinical gaps in care
  • Uses data to develop intervention strategies to improve outcomes
  • Supports quality improvement program studies with work that ranges from accessing and analyzing provider records, maintaining databases, and researching to identify members’ encounter history
  • Designs practice-level quality transformation through targeted clinical education and approved materials related to HEDIS / state-specific quality measures for provider and staff education during field visits
  • Engages providers in strategies to improve outcomes through collaborative partnerships
  • Develops and implements PIPs internally and across MCOs
  • Reports quality improvement and performance outcomes to MLTC
  • Bachelor’s degree in science or equivalent work experience
  • Current unrestricted RN licensure for the state of Nebraska (preferred), or, at a minimum, a Certified Professional in Health Care Quality (CPHQ) or Certified in Health Care Quality and Management (CHCQM) or have comparable experience and education in data and outcomes measurement
  • More than five years of clinical or field-related experience
  • More than two years of experience in quality improvement or a related field such as Six Sigma
  • Experience working in Medicaid or Medicare
  • Knowledge of one or more clinical standards of care, preventive health standards, CMS standards, HEDIS, NCQA and governing and regulatory agency requirements
  • Health care and insurance industry experience, including regulatory and compliance
7

Lead Quality Improvement Coordinator Resume Examples & Samples

  • Analyze and evaluate data to ensure accuracy, reliability, and validity. Ensure alignment with measurement methodologies. Update Contract, website, and any other document that references performance measures as methodologies and/or performance measure requirements change
  • Oversee and participate in validation activities to ensure that reported data are collected according to measurement methodology and meet the population, service and other indicator criteria; recommend improvements for accuracy, operational enhancements and policy changes, to support the most effective and efficient use of health care resources
  • Lead Agency efforts related to Quality Improvement Reporting, including the CMS 416, CARTS, MACPro, and quarterly/annual Waiver Update reports. Analyze, interpret and disseminate results of performance measures, PIPs and other studies to Division management and Agency leadership; ensure that results are publicly reported via the AHCCCS website and/or other means
  • Evaluate deliverables and performance results for assigned Contractors and recommends appropriate regulatory action when Contractors do not meet AHCCCS performance standards (e.g., require corrective action plan, sanction, etc.)
  • Take a leadership role in the Agency’s External Quality Review process. Document processes and provide appropriate data to the EQRO
  • Recommend quality improvement activities/strategies for implementation and leads or participates in work groups with Contractors and other stakeholders to implement approved activities/strategies
  • Strong understanding of methodology requirements, including but not limited to HEDIS and CMS Core Measure sets, as well as current quality improvement and health care theories and practices
  • Proficient in medical record review/evaluation, analyzing and trending data, writing comprehensive reports, and presenting trends to large multi-disciplinary teams and or community stakeholders
  • In-depth knowledge of problem solving and technical writing; project management methodologies; data validation methods; and statistical and data analysis and research methods
  • Excellent written and oral communication skills, including technical writing report publication and group presentations (within and/or outside the agency)
  • Demonstrated experience with organizational skills that result in prioritization of multiple tasks and ability to meet deadlines
  • Certified Professional in Healthcare Quality
  • At least one year experience working in a managed care environment
8

Quality Improvement Coordinator Resume Examples & Samples

  • Provides support for the quality improvement functional area
  • Completes special projects or assignments as needed to meet initiatives and/or objectives of department
  • Assists and coordinates QI projects as needed
  • Maintains all department files in an organized, accurate manner
  • Assists with preparations for meetings by typing agendas, attachments and minutes
  • Maintains supply levels, equipment maintenance, communications and records
  • Maintains and secures files of QI activities
  • Directs communication to the appropriate staff
  • Required or equivalent work experience
  • Required 2+ years of experience in medical office HMO or hospital environment performing adminstrative duties with a clincal focus
  • Required Other Experience with medical terminology
  • Intermediate Ability to communicate and make recommendations to upper management
  • Intermediate Ability to work in a fast paced environment with changing priorities
  • Intermediate Other Ability to communicate effectively with people at all levels
  • Intermediate Other Ability to arrange their own work day
  • Required Intermediate Microsoft Access
9

Quality Improvement Coordinator Days Resume Examples & Samples

  • Strong computer skills in Microsoft Word, Excel and PowerPoint- required
  • Excellent communication skills- written, oral and presentation skills- required
  • Analytical ability to interpret data trends- required
  • Acts independently and demonstrates organizational and problem solving skills- required
10

Clinical Quality Improvement Coordinator Resume Examples & Samples

  • Bachelor's degree in related field or equivalent healthcare education and training
  • Minimum of 2 years of related work experience such as healthcare quality improvement activities, informatics and/or project management
  • Excellent MicroStrong written and verbal communication skills
  • Microsoft (including Access database programming and Excel) and Vizio skills
  • Basic statistics
  • Strong data analysis skills
  • Lean, Six Sigma, CPHQ
  • Knowledge of Centers for Medicare and Medicaid Transforming Clinical Practice Initiative (TCPI)
  • Training or experience in health care informatics, including: Data warehousing; Time sequence charts; Reports; Access database programming
11

Quality Improvement Coordinator Resume Examples & Samples

  • Maintains and updates department policies/procedures
  • Coordinates provider profiling activities
  • Organizes and may conduct Policy and Procedure Committee meetings
12

Quality Improvement Coordinator Resume Examples & Samples

  • Under the direction of Director of Quality Improvement, organizes and maintains medium to large scale projects, including documentation of project proposal, project scope, project plan, time lines and reporting
  • Establishes and maintains a tracking and filing system for documents & projects across the health-plans; distributes materials
  • Participates and makes recommendations for process improvements in work organization, communication and efficiency with internal and external customers. Supports on-going monitoring of quality assurance processes by running the system reports, conducting trouble shooting and providing feedback to plans
  • Assists with data entry and data base management to effectively compile data for trending/reporting. Assists with preparation of reports. Able to identify, specify, retrieve data from a variety of sources. Able to manipulate data sets and conduct qualitative analysis (tabulations, averages, ranges
  • Develops, implements and maintains time table matrix / work plans to ensure timely and successful project completion. Prepares and submits project update reports to Director of Quality Improvement
  • Conduct focus groups in service delivery area as needed to ensure member needs are being addressed; assist in health fairs as appropriate
  • Educate members on covered services available to them, including preventive services
  • Participate in department projects as requested to gather data on
  • Make recommendations to management of any changes needed to improve the care provided or the way delivered
  • Refer members to community resources available to meet member needs not available from Molina
  • Ability to abide by Molina's policies
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
13

Quality Improvement Coordinator Resume Examples & Samples

  • Required A High School or GED required
  • Required 2+ years of experience in medical office, HMO or hospital environment performing administrative duties with a clinical focus
  • Required experience with medical terminology
  • Advanced demonstrated written communication skills
  • Advanced demonstrated interpersonal/verbal communication skills
  • Intermediate ability to communicate and make recommendations to upper management
  • Intermediate ability to work in a fast paced environment with changing priorities
  • Intermediate ability to communicate effectively with people at all levels
  • Intermediate ability to arrange their own work day
  • Required intermediate Microsoft Word
  • Required intermediate Microsoft Excel
  • Required intermediate Microsoft PowerPoint
  • Required intermediate Microsoft Outlook
14

Quality Improvement Coordinator Resume Examples & Samples

  • Exhibits responsibility and accountability for assigned work, works independently
  • Must balance multiple tasks/projects while meeting organizational standards
  • Must be extremely detail oriented and able to follow through on all assigned tasks
  • Uses various software programs to develop, generate and update documentation
  • Works effectively as a team member
  • Develops, implements and maintains quality monitoring and analysis processes that support the Performance Improvement Plan
  • Researches applicable evidence based best practices in developing chart abstraction and analytical tools for assigned performance improvement monitors/indicators
  • Uses generated outcomes and process data/reports for further analysis creating final reports for committees that includes conclusions, recommendations, actions and follow up
  • Uses generated outcomes and process data/reports for further Level I and Level II peer review procedures under the supervision and direction of the Quality/Risk Management Director
  • Compiles and submits individual medical staff member and allied health comparative data profiles that supports medical staff credentialing process
  • Participates in investigating hospital and medical staff identified concerns for further review and analysis according to the Performance Improvement Plan
  • Actively participates or leads Performance Improvement Teams
  • Educates hospital and medical staff in the facility PI Program as assigned
  • Graduate from accredited school of nursing required. BSN preferred
  • One (1) year experience in a health care setting in a Quality Coordinator (or equivalent) role preferred
  • Three (3) to five (5) years’ clinical experience in a hospital setting (Hospital quality experience preferred.)
15

RN, Quality Improvement Coordinator Resume Examples & Samples

  • Minimum of 1 year clinical experience
  • Experience working with quality management across continuum teams
  • BSN or other health related degree
  • Knowledgeable of Home Health CMS and State rules and regulations and Joint Commission standards
  • Demonstrated knowledge of home care service delivery concepts; quality standards; utilization management; and continuous process improvement
  • Excellent written and verbal English communication skills
  • Demonstrates ability to drive processes
  • Ability to exemplify good interpersonal and facilitation skills with all levels of employees and management
  • Strong problem solving, time management, and financial management skills
  • Ability to use qualitative and quantitative data, performance improvement tools and methodologies
  • Demonstrates knowledge of QAPI principles relative to the organization of information, the analysis of data, and the identification/ initiation of opportunities for improvement
  • Demonstrates ability in development and use of spreadsheets, graphics, word processing, and data management
  • Demonstrates ability to organize and prioritize work efficiently
  • Current and valid California Registered Nursing license
16

Clinical Competency & Quality Improvement Coordinator Resume Examples & Samples

  • Develops and manages continuing educational programs; assures completion of all required training, in collaboration with Field Operations Managers, Medical Assistants, Regional Care Coordinators and other departments as required
  • Assesses and prioritizes ongoing educational needs through assessing Paladina data and available reports, literature review, employee surveys and professional contacts. Participates in Quality Assurance / Quality Improvement (QA/QI) activities and policy and procedure review
  • Develops and provides (when necessary) direct clinical instruction to new Medical Assistants in basic primary care clinical skills and procedures including but not limited to patient rooming, vitals, phlebotomy and patient charting and documentation
  • Monitors state and federal regulations to ensure Paladina training programs meet or exceed requirements. Maintains current clinical knowledge and ensure that clinic training and education needs are met in accordance with Paladina’s policies, procedures, and guidelines, as well as OSHA, HIPAA, federal state and local regulations. Also provides updates and training on changes in regulations
  • Evaluates the effectiveness of all educational activities. Evaluations will include attendee satisfaction and competence. Provides periodic reports on educational activities
  • Provides continuing education and in-services/materials to teammates to improve knowledge base and any needed continuing educations requirements needed by the clinical personnel
  • Collaborate with the Learning and Development manager to create educational modules that are delivered to teammates across the country
  • Provides infection control oversight and guidance for all clinic locations
  • Registered Nurse in the state of Colorado
  • 2+ years' nursing experience required
  • Understanding of adult education and learning
  • Able to provide positive learning environment through strong leadership skills and positive role modeling
  • Delivers educational materials in a variety of settings (e.g. classroom, self-paced modules, virtual, etc.)
  • Demonstrated expertise in effectively teaching adult learners with different learning styles
  • Understanding of QA/QI
  • Able to communicate effectively verbally and in writing
  • Willingness to travel up to 30%
17

Quality Improvement Coordinator Resume Examples & Samples

  • Assist with coordination of quality improvement activities
  • Coordination of Meeting Activities
  • Drafting Minutes
  • Chart Audits
  • Report Creation and Distribution
  • Assist with the process of data collection and the analysis of data related to Quality Improvement Activities
  • Process improvement projects
  • Work with the staff to promote quality practices and assess effectiveness of programs and initiatives
  • Work with Organizational Leadership to create policies and programs
  • Compile study and report findings within appropriate time frames
  • Assist with the monitoring of compliance with quality assessment and improvement
  • Assist the Director of Managed Care and Quality in working closely with Quality Medical Director and clinical departments to ensure optimal and efficient quality improvement
  • Assist with accreditation readiness
  • Gather and report data to meet quality payment program requirements
  • Perform other duties and professional responsibilities as needed
18

Quality Improvement Coordinator Resume Examples & Samples

  • Maintains denial templates and generates denial letters
  • Tracks denial data
  • Collects data for appeals and grievances for health plans and QIC clinical review
  • Provides feedback to Clinical Services Supervisor regarding process improvement
  • Performs data entry as required
  • Prepares tracking reports
  • Files / faxes
  • Access to reliable transportation
  • 3+ years of experience in managed care environment, medical office or clinic setting, preferably in a QM Department
  • Knowledge of UM / QM processes and principles
  • Knowledge of training and audit principles and processes
  • Knowledge of and experience with medical coding
  • Knowledge of general IPA operations
  • Computer literate in Microsoft Word and Excel
  • Strong ability to work effectively with nurses, physicians and other clinical and operational staff, both written and verbally
  • Flexible and adaptable of schedule to attend various meetings and / or promotional events
19

Quality Improvement Coordinator Resume Examples & Samples

  • Performs retrospective and concurrent review of core measure patients in compliance with National Hospital Inpatient Quality Measures and regulatory agencies such as Joint Commission, CMS, HQID project, American College of Cardiology, etc
  • Participates in the education of medical staff, employees, leadership and Board on quality and performance indicators selected by the organization as well as the requirements and implications of these measures for clinical practice
  • Performs retrospective and concurrent review of specific focused studies (including procedures, diagnosis and other studies) requested by medical staff, hospital departments and committees
  • Flags and documents variances for selected indicators and variables for focused studies and implements indicators for medical staff, peer review including OPPE and FPPE required by TJC
  • Provides continued improvement consulting services to customers
  • Participates in data extraction for submission of required data electronically to QNET/ACC/TJC/CMS/MHCC. Facilitates the organization's responses in order to meet established time frames for submission
  • Identifies and interprets objective and subjective data found in the medical records
  • Abstracts and reports PI information in appropriate format to detect patterns and/or problems in the delivery of care
  • Coordinates Medical Staff (departmental) peer reviews in cooperation with the Review Committee Chairmen
  • Maintains current knowledge of TJC, CMS, ACC national quality indicator guidelines, Magnet and NDNQI and assesses compliance for assigned areas
  • Graduation from an accredited school of Nursing
  • Minimum 5 years of clinical experience
  • Minimum 2 years combined QA, QI, RM, UR or CM experience
20

Quality Improvement Coordinator Resume Examples & Samples

  • Provides effective Project Management/Leadership to ensure completion of Medical Center Quality and Performance Improvement projects to meet goals and objectives
  • Clinical Expertise: Demonstrates clinical expertise in specific patient population(s) related to projects managed
  • Technical Execution: Demonstrates technical execution in collection, verification and analysis of data
  • Leadership & Training/Development: Provides leadership and training/development to project team members
  • Communication & Interpersonal Skills: Communicates effectively with all levels of internal and external personnel
21

Quality Improvement Coordinator Resume Examples & Samples

  • Completes non-clinical review of charts and provides initial decision on eligibility; also responsible for reviewing re-assessments
  • Prepares and triages charts ready for review
  • Provides feedback on documentation errors while guiding towards documentation improvement
  • Prepares information used for management presentations and submission to various internal and external customers including but not limited to state regulators, CMS auditors and internal auditors
  • Prepares and sends communications to vendors and/or provider's office in a manner that is clear and actionable
  • Data entry input, as well as documents, tracks and queries data in appropriate reporting tools
  • Organizes and reports data in databases, spreadsheets and graphics
  • Generates standard reports for Quality team as needed
  • Follows the process through to ensure it is completed and/or resolved
  • Assists clinical reviewers with other tasks such as system navigation, as needed
  • Supports team in day to day functions, accreditation activities and ad hoc reporting as required. ​
22

Quality Improvement Coordinator Resume Examples & Samples

  • Coordinate local, Plan-specific quality improvement activities
  • Conduct monthly beneficiary satisfaction surveys and summarize results
  • Incorporate results of annual member and provider surveys into provider follow-up and training
  • Identify trends and share results with ASO network providers
  • Coordinate and carry out routine clinical chart reviews
  • Prescribe and monitor provider-specific corrective action plans
  • Participate in annual provider trainings
  • Follow-up on member-generated issues and concerns
  • Participates in County ASO QI meetings quarterly and other meetings as necessary
  • Ability to communicate effectively orally and in writing with providers and members
23

Quality Improvement Coordinator Vascular Surgery Resume Examples & Samples

  • 2-3 years hospital experience with knowledge of medical diagnosis and treatment essential
  • Must be able to communicate with tact and confidentiality
  • Database management preferred
  • Experience with Excel and PowerPoint preferred
24

Quality Improvement Coordinator Resume Examples & Samples

  • Conducts targeted record reviews to identify trends and discover practices needing improvement
  • Practices confidentiality principles set by the agency and federal HIPAA guidelines
  • Adheres to departmental requirements for required training
  • Identifies specific learning needs and goals and collaborates with leadership in developing a plan to meet them
  • Minimum of two years as a field clinician in a certified home health agency
  • Quality Improvement experience desired
  • Coding experience a plus
  • Knowledge of federal and state regulations pertinent to home health
  • Strong assessment skills
  • Ability to mentor and educate clinical home care staff both onsite with patients and in the office setting
  • Team Player. Scheduled Hours Full-time Days, Monday through Friday
  • HomeCare EliteTM, which annually names the top 25 percent of home health agencies in the United States based on quality of care, quality improvement and financial performance, first named Lahey Health at Home to its select list in 2011 and annually thereafter
  • Home Health Quality Improvement National Campaign Agency of the month (AOTM)
  • Fazzi Associates has also honored us with its Patient Satisfaction Award of Distinction, presented annually to home health organizations that have demonstrated superior performance in overall patient satisfaction results
25

Quality Improvement Coordinator Resume Examples & Samples

  • Reviews OASIS assessment and OASIS coding for accuracy. Ensures the plan of care on the 485 reflects the accuracy of the OASIS assessment and primary focus. Ensures correlation between the patient’s needs as identified in the clinical documentation and the resources allocated as indicated in the plan of care
  • Communicates to staff on an on-going and regular basis, the current agency and individual performance relative to benchmark data
  • Mentors and educates staff on the most efficient ways to assess the patient/client needs, plan for the most cost-effective delivery of care, and implement the plan of care while ensuring high quality clinical outcomes. Evaluates education programs, and competency testing to meet education and training needs to ensure the knowledge and skill level necessary for the provision of quality care and compliance with federal, state and accrediting body safety regulations
  • Identifies patients who are appropriate for Care Path use and ensures that the patient is on the pathway, and that the patient and family/caregiver is in agreement with the plan
  • Researches alternative methods and practices to enhance care delivery and to move the patient to desired outcomes
  • Maintains department resources in a manner consistent with department budgets and departmental activity. Works in an efficient manner to streamline the revenue cycle. Evaluates for opportunities to improve processes and work flows. Communicates those opportunities to the administrative team and participates in projects to improve agency performance
  • Understands payer principles, terminology of managed care, and the goals of the managed care industry. Demonstrates knowledge of regulations related to provision of and reimbursement for home care services
  • Correlates Case Mix Weight, HHRG scores, and ICD-9 coding for maximum services delivery, optimal outcomes, and fiscally responsible resource management
  • Evaluates trends in quality improvement scores as it relates to OASIS completion. Collaborates with the Quality Improvement Manager to develop corrective action plans. Utilizes appropriate home care staff (administration, Team Managers, Quality Manager, etc) when appropriate to accomplish goals
  • Serves as a knowledge resource to the clinical staff by actively researching and maintaining expertise in the area of OASIS/485 review. Responsible for keeping abreast of industry, governmental, and regulatory updates and preparing the agency to maintain optimal effectiveness and regulatory compliance
26

Rn-quality Improvement Coordinator Resume Examples & Samples

  • Minimum 5 years of health care experience
  • Minimum 2 years of Home Health experience that includes quality measures or audit functions
  • Current RN license in practicing state
  • Bachelor of Science in Nursing degree preferred
  • Firm working knowledge of concepts, practices and procedures and ability to use in varied situations
  • Knowledge of regulatory standards for the home health industry, quality improvement, utilization review, and risk management
  • Able to some advanced skills that allow employee to adapt and meet some complex or non-routine situations
  • Strong project/process management skills with the ability to influence and problem solve
  • Ability to create complex documents, spreadsheet analysis models, and advanced graphics
  • Excellent ability to draft, edit, and proofread internal and external correspondence, ensure files are organized, manage electronic schedule as appropriate
  • Ability to work in a fast paced, multi-task environment with competing priorities
  • Excellent interpersonal/listening skills and demonstrated relationship building skills
  • Possess a responsible, detail-oriented, results-driven work ethic
27

Rn-quality Improvement Coordinator Resume Examples & Samples

  • Support quality improvement activities including practice coaching, data management and reporting, health insurance incentive programs, population health management and other value-based reimbursement programs
  • Monitors key internal & external clinical quality metrics reports, provider dashboards, performance based compensation reports & other performance reports. Develops/deploys targeted training to improve patient outcomes & increase value to the client organization
  • Collaborates with leadership to identify opportunities for improvement and develops supportive plans to target opportunities using PI/QI improvement methods and tools
  • Identifies providers for targeted outreach for QI Initiatives and Quality Improvement metrics (e.g. underperformers or those not meeting baseline goals/benchmarks)
  • Develops and updates educational materials regarding data capture in clients' EMRs to maximize quality metric outcomes
  • Develops & updates educational materials for new provider & staff orientation, ongoing/ad hoc provider education & clinical staff education
  • Educates staff and providers on quality and population health initiatives to maintain or improve performance
  • Provides ongoing training and mentoring of clinical informatics specialists, system analysts and data analysts to support providers/offices regarding clinical documentation and quality metric satisfaction in the electronic health record
  • Oversees clinical data collection, completes clinical chart reviews and provides expertise to Population Health team to complete chart reviews for
28

Quality Improvement Coordinator Resume Examples & Samples

  • Support quality improvement activities including practice coaching, data management and reporting, health insurance incentive programs, population health management and other value-based reimbursement programs
  • Monitors key internal & external clinical quality metrics reports, provider dashboards, performance based compensation reports & other performance reports. Develops/deploys targeted training to improve patient outcomes & increase value to the client organization
  • Collaborates with leadership to identify opportunities for improvement and develops supportive plans to target opportunities using PI/QI improvement methods and tools
  • Identifies providers for targeted outreach for QI Initiatives and Quality Improvement metrics (e.g. underperformers or those not meeting baseline goals/benchmarks)
  • Develops and updates educational materials regarding data capture in clients' EMRs to maximize quality metric outcomes
  • Develops & updates educational materials for new provider & staff orientation, ongoing/ad hoc provider education & clinical staff education
  • Educates staff and providers on quality and population health initiatives to maintain or improve performance
  • Provides ongoing training and mentoring of clinical informatics specialists, system analysts and data analysts to support providers/offices regarding clinical documentation and quality metric satisfaction in the electronic health record
  • Oversees clinical data collection, completes clinical chart reviews and provides expertise to Population Health team to complete chart reviews for
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Quality Improvement Coordinator Resume Examples & Samples

  • Demonstrates effective skills in all forms of communication
  • Develops, implements and maintains quality monitoring and analysis processes that support the Performance Improvement Plan, patient safety, risk management programs and outcome improvement efforts
  • Uses generated outcomes and process data/reports for further analysis creating final reports for committees that includes conclusions, recommendations, action and follow up
  • Uses generated outcomes and process data/reports for further Level I and Level II peer review procedures under the supervision and direction of the QM Director
  • Actively leads core measure projects and serves as a mentor to staff in regard to these projects
  • Assists in investigation of incidents that could lead to professional/general liability claims
  • Assists in analyzing occurrences and identifies patterns as evidence for decision making
  • Assists with development and implementation of educational programs for employees, medical staff and board members based on analysis of risk assessments, historical and concurrent occurrence and claims data and national trends
  • Assists appropriate medical staff and nursing committees in the resolution of peer review, medical quality of care and nursing quality of care issues posing clinical risk exposures
  • Assists in the identification, evaluation and trending of employee safety issues
  • In accordance with all applicable regulatory standards and in cooperation with the hospital’s Education Plan assists
  • With: design, implementation, coordination and evaluation of educational activities related to assessed learning
  • Needs, policies / procedures, standards of care, equipment or knowledge deficits
  • Participates in clinical risk assessments and analysis and assists in the development of corrective action plans
  • Disseminates information and research related to changes in regulatory requirements and clinical research pertinent
  • To potential liability exposures and risk issues
  • Participates in the development and review of the Risk Management Program, to include policies and procedures
  • Associates Degree in nursing required
  • Bachelor’s degree in nursing preferred