Major Responsibilities:Coordinates, facilitates, implements and participates in care management and quality improvement initiatives/teams across Aurora Health Care in assigned geographical areas. Develops process improvement plans with leadership and departments throughout the organization to analyze, monitor and ensure high levels of quality and performance. Identifies opportunities for improvement, makes recommendations for change, and leads the implementation of best practices to meet established goals. Promotes cross-departmental communication, collaboration, and performance improvement as a means of achieving cost-effective, high quality care.Coordinates, facilitates and implements best practice strategies for assigned patient populations to meet quality and cost goals.Designs and documents assigned projects to demonstrate the quality levels delivered to patients, while applying Aurora's approach to quality. Uses statistical techniques to analyze and display clinical data using measurement tools and systems, as appropriate.Interprets and communicates care management and quality results in a way that the customer understands. Meets individually with providers and staff to assist with problem-solving, recommend and facilitate improvement strategies. Measures and evaluates attainment of goals. Manages multidisciplinary quality improvement teams and projects to support the accomplishment of care management and accreditation (as appropriate) goals.Completes medical record reviews, compares current practice against best practice guidelines and provides recommendations to improve patient care.Provides leadership and consultative services at least quarterly to departments and services within the organization in achieving regulatory, accreditation, and organizational compliance in quality, safety and in performance management and improvement activities. Serves as a resource on external regulatory requirements relative to care management activities.Maintains awareness of and notifies leadership of actual or potential risk situations. Gathers information and provides input regarding risk management issues as delegated by immediate supervisor. Reviews, trends and reports results at least quarterly of quality and care management related third party visits, chart reviews, surveys, and other data to appropriate committees, departments and administration.Serves as an educator, communicator, and resource to physicians, providers and staff to understand care management, quality improvement and accreditation (as appropriate) objectives. Develops educational programs regarding care management, quality initiatives and strategic objectives. Collaborates with nursing and/or patient education, physicians, providers and staff to review, design, and coordinate the use of patient education materials. Establishes new or utilizes existing mechanisms to communicate patient education resources across sites and departments.Drives development of improved Electronic Health Record tools to support Care Management Quality in collaboration with key functional departments and leadership.Coordinates and/or leads care management and quality committee meetings. Ensures all key stakeholders receive consistent communication across departments and sites. Shares successful process improvement and care management practices.
Licensure, Registration, and/or Certification Required:None Required.
Education Required:Bachelor's Degree in Quality Management or related field.
Experience Required:Typically requires 5 years of experience in health care or clinical quality improvement.
Knowledge, Skills & Abilities Required:Knowledge of quality improvement principles, project management, and team facilitation.Knowledge of federal, state and external health care regulations and standards and ability to research those regulations. Knowledge of evidence based, best practice resources to promote efficiency and effective outcomes.Knowledge and use of process improvement methods, statistical tools and evidence based, best practice resources.Demonstrates strong problem solving, leadership, conflict mgmt. and team building skills.Knowledge of medical terminology, clinical concepts and disease management.Ability to analyze complex data and communicate sensitive information. Excellent interpersonal, written and verbal communications skills.Proficient in the use of Microsoft office suite or similar products. Ability to create reports, graphs and other visual presentation materials, and effectively maintain statistical data.Demonstrated ability to analyze complex data and communicate sensitive information to improve patient care. Detail oriented and able to prioritize and organize data and complex projectsCertification AddendumTeam members will maintain annual educational requirements for hospital based certifications (e.g. DNV, CARF or others).
Physical Requirements and Working Conditions:Must be able to drive to various sites so therefore will be exposed to weather and road conditions. Operates all equipment necessary to perform the job.Exposed to normal office environment.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.