Quality Review Analyst II

Position Summary:

Supports effective operations of the quality improvement and organizational excellence in areas by assisting with performing quality and compliance related activities, supporting abstraction process based on CMS and The Joint Commission (TJC) standards and other related activities. May coordinate medical staff quality and appropriateness review activity.

Essential Functions and Responsibilities:

1. Manages concurrent and/or retrospective review of medical record data according to established criteria.
2. Abstracts and analyzes clinical and health data elements from multiple sources.
3. Coordinates timely collection of data from multiple internal data sources.
4. Participates in data collection and reporting through internal and external authorities (e.g., CMS, TJC).
5. Initiates collaboration with personnel in other departments to improve data accuracy, collections, and completeness to achieve quality metrics set by various regulatory groups.
6. Develops, coordinates, and applies statistical analysis when producing periodic documents or presentations according to reporting requirements and schedule.
7. Updates reports based on changes to quality and regulatory reporting.
8. Engages appropriate resources to troubleshoot and resolve data issues. Monitors and implements changes to improve data validity.
9. Communicate directly with vendors, develops and maintains database, installs and tests software upgrades.
10. Serves as an expert in the implementation of new and existing policies, procedures, parties, and standards.

Qualifications:

Required

• Associate's degree in nursing, healthcare administration, business administration, health information management/technology, or related field from an accredited educational institution.
• Experience related to healthcare data quality for three (3) years.

Preferred:

• Bachelor’s degree in nursing, healthcare administration, business administration, technical/analytical field, or related field from an accredited educational institution.
• Certification in Quality Improvement/ Patient Safety (i.e., CPHQ, ASQ, CQIA, Team STEPPS Master Trainer, Project Management).