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Quality Risk Nurse Coordinator, Clinical Coordinator (RN)

Large, established managed care organization in Downtown, Manhattan is looking for long term contractors.  These roles have flexible hours within normal business days and times. 

Quality Risk Coordinator, Clinical Coordinator

Essential Duties:

Under the supervision of the Manager/Supervisor, the primary function of the Quality Risk Coordinator is to promote the delivery of high quality health care by implementing the quality investigation process and clinical quality improvement studies in accordance with Quality Improvement Program Plan.

• Assist in the implementation of quality assurance activities according to the approved Quality Improvement Plan.
  
• Identifies and processes known or suspected systemic and/or quality of care problems, and variation from the standards of care by auditing core operations, patient care processes, and medical record documentation in compliance with regulatory requirements.
  
• Identifies the scope of the problem, root cause analysis, and developing reports from all assessment and information sources available.

·        Facilitates the development of and monitors corrective action plans to address identified systemic and/or individual quality of care issues, adverse outcomes, and strategies to reduce the likelihood of reoccurrence. Tracks and trends all quality of care issues and reports resolution to appropriate management staff.

• Participate in developing a Safety Program designed to address measurable improvement in safety based on defined indicators.
  
• Supports quality improvement activities necessary to meet the requirements of URAC, NCQA and regulatory agencies including, but not limited to, data collection, surveys, medical record reviews, and quality improvement initiatives.
  
• All other duties as required by Quality Management.

 

Knowledge Skills & Abilities:

·        Excellent interpersonal and communication skills are required. Including verbal and formal presentation skills sufficient to provide clear, concise and organized written analyses of findings.

 

Qualifications:

• Current Licensed Registered Nurse, Licensed Practical Nurse or Physician Assistant in NY State.  Must have professional experience in providing direct patient care.
  
• Must have two (2) or more years of experience in quality assurance, CQI, medical review, auditing, and survey administration; managed care experience preferred.

·        Ability to proficiently read and interpret medical records required.

·        Must be capable of working under strict deadlines and must be detail-oriented and have strong organizational skills.

·        Proficiency in Word, Excel, and Flowcharting required.  Access database basics desirable.