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Summary:
Provides care under the direct supervision of the Nursing Supervisor of Quality Improvement, utilizing physician approved patient protocols according to established standards and best practice guidelines.Facilitates the communication between patient/caregiver, physician and the outpatient care team to optimize health and wellness, reduce inpatient admission, reduce re-admissions and improve medical stability in the patient population served. Responsible for the coordination of HEDIS data gathering process by evaluating the quality and completeness of clinical documentation processes. Performs quality medical record reviews, assisting providers and staff in the improvement of clinical documentation process, identifying trends and gaps in care, maintaining accurate records of review activities, ensures all data submitted to the health plan meets the HEDIS technical specifications for medical records. Participates in the development and ongoing implementation of quality improvement activities by providing regular and ongoing physician/staff support and education.
Requirements:
Work Type:
Full Time