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Quality Improvement Specialist in Harrisburg, PA at KEPRO

Date Posted: 12/30/2017

Job Snapshot

Job Description

KEPRO, INC.

JOB DESCRIPTION

JOB TITLE:                QualityImprovement Specialist

REPORTS TO:           OperationManager or Operation Director

DEPARTMENT:        Operations

FLSA STATUS:         Exempt

Summary Description

Plans, develops and monitors the internal quality program forall KEPRO activities related to assigned contracts.  Performs quality record reviews on reviewstaff.  Prepares all quality relatereports.  Identifies quality trainingneeds of staff and coordinates with Corporate Training Team relative to thoseneeds.  

Accountabilities

  • Oversees and facilitates all Quality Improvement(QI) activities for assigned contracts.
  • Maintains IQC databases and/or other requireddocumentation to measure quality performance. Modifies data capture as necessary to reflect changes in contractrequirements.
  • Develops Tools to be utilized in measuring staffperformance measurement. (Accuracy & Inter-rater Reliability) and other QIstudies.  Prepares reports and documentsas indicated/required.
  • Coordinates with the Operational Leadership andthe Medical Director to monitor results for physician reviewers. Identifiestraining needs and coordinates with Corporate Training Team.
  • Identifies training needs and coordinates withthe Corporate Training Team in developing educational programs for the contractreview staff.
  • Develops or assists in developing tools tomeasure effectiveness indicators and outcome measurements to determine whetherand to what extent the training effort produces the results desired to theparticipants.
  • Analyzes quality review activities within theassigned contract.  Present findings,conclusions and recommendations to Operational Leadership, and the MedicalDirector.  Identifies opportunities forimprovement and recommends changes to record review processes as needed.
  • Develops standardized Quality ManagementReporting tool to be utilized in providing quality information back to theclient and internal staff.  Reviewscompleted reports for measurement accuracy, action plans if necessary andongoing plans, prior to being sent out to clients.  . 
  • Promotes a culture of quality performance andquality improvement through out the organization.
  • Develop tools to measure Gold Standardmonitoring for reviewer activities.  Workwith KePRO Corporate quality team to develop tool to be used that will measureIRR.  Analyze outcome reports andidentify training needs and coordinate with Corporate Training Team.  Ongoing monitoring to assess effectiveness oftraining.
  • Develops, coordinates and monitors the customersurvey project performed four times per year, Analyzes the outcomes and identifies areas of improvement and works withthe Operational Leadership, and the Medical Director and coordinates with theCorporate Training Team to develop training modules for staff to improveresults
  • Assists in ongoing compliance with Federal,State and national accreditation standards/regulations.
  • Utilizes quality improvement methods, tools andtechniques.
  • Assists with other duties as assigned.

The list of accountabilities is not intended to beall-inclusive and may be expanded to include other duties that management maydeem necessary from time to time 

Qualifications

  • Active RN, LPN licensed health professional
  • Bachelor’s degree in related discipline or equivalentcombination of experience and education. 

Skills, Knowledge, Abilities(SKA)

  • Ability to communicate effectively (verbal and written)persons of diverse backgrounds and educational levels.
  • Excellent organization and interpersonal skillsrequired.
  • Ability to prioritize and manage multiple assignmentsand adjust to changing priorities.
  • Skilled in working with others in a team environment.
  • Must be proficient in MS Office applications (Word,Excel, PowerPoint, and Access).
  • Proven skills using QI tools, methods and techniquessuch as:
  • Spreadsheet charting and graphing (Essential)
  • Knowledge of NCQA and URAC (Preferred)
  • Knowledge of InterQual (Preferred)
  • Knowledge and use of QI survey tools (Preferred)
  • Strong facilitation and presentation skills desirable.

Experience

  • Experience in quality assurance/quality improvement,preferred.
  • Two (2) years relevant experience including designing,developing and delivering educational sessions.
  • Experience assisting in developing and monitoringinternal performance indicators.
  • Recent clinical experience preferred.      

Mental and PhysicalRequirements           

 

The physical demands described here are representative ofthose that must be met by an employee to successfully perform the essentialfunctions of this job.  Reasonableaccommodations will be made as required by law in an attempt to enable anindividual with a disability to perform the essential functions of this job.While performing the duties of this job, the employee is regularly required tosit for prolonged periods of time; key and/or control objects; interactextensively with internal and external customers; occasionally lift and/or moveobjects weighing up to 10 pounds; and occasionally travel.

 

Equal Opportunity Employer