CommuniCare Health Services Corporate RN Quality Improvement Nurse in Blue Ash, Ohio
CommuniCare Health Services is a fast-growing provider of long term care with over 80 facilities located in 7 states. CommuniCare is dedicated to our goal of creating Caring Communities where staff, residents and families join hands to overcome their daily challenges.
Due to continued growth, CommuniCare is currently recruiting for the key position of Quality Improvement Nurse for our Medicare Advantage Plan. The position of Quality Improvement Nurse is part of Clinical Healthplan Operations. This position will report to the VP of Healthcare and Quality Operations and have strong working relationships with the Chief Medical Officer. The Quality Improvement Nurse must be able to participate in QI activities including continuous quality improvement, performance improvement plans, HEDIS and Star improvement activities. The QI nurse is responsible for strategic planning and interpretation of quality data. The QI Nurse will collaborate with other departments to ensure compliance with all state, federal and CMS regulations.
JOB DUTIES & RESPONSIBILITIES
Works in conjunction with the Chief Medical Office and VP Healthcare Quality & Operations to drive CQI and PIPs
Participates in HEDIS & Star measure initiatives that include focused medical record review to identify non-standard supplemental data.
Conducts medical record review to assist in identification of gaps in care and compliance with clinical practice guidelines
Participates in the Clinical Quality Improvement activities and projects to improve clinical interventions and improvement quality of care and services for the members
Upholds the highest ethical standards in facilitating CQI with a focus on best possible member care.
Participates in assigned meetings and committees.
Participates in the development or revision of quality processes or procedures.
Supports the administrative tasks related to CQI, PIPs and the Quality Improvement Committee
Works with Acute care facilities on developing a discharge plan
Collaborates with Case Managers to drive CQI and trending for PIPs.
Passionate about transforming our care system for those who need it most
Driven to do well by doing what’s right
Willing to thoughtfully disrupt the status-quo and excited to work in a rapidly evolving start-up environment
QUALIFICATIONS & EXPERIENCE REQUIREMENTS
Licensed Bachelor of Nursing (BSN) in Ohio) in good standing with the ability to become licensed in MD and IN
Minimum of 3-5 years’ experience in Quality Improvement required.
Previous clinical experience in post-acute care preferable.
Experience in Medicare Advantage Special Needs Plans and benefits.
Proficiency with a variety of data applications.
Excellent interpersonal communication, written, and organizational skills required.
3+ years of Healthcare writing experience with processes/policies/procedures
Microsoft Office/Suite proficient (Excel, PowerPoint, Word, Visio, etc.)
Project management experience a bonus
Must have reliable transportation and be able to travel to provider sites on occasion
Must have integrity and a strong ethical compass.
Must be flexible, able to work independently, and able to achieve deadlines and deliverables with minimal supervision.
Must be excited by the opportunity to work within an integrated delivery system.
Must have strong communication skills and the ability to work effectively with people coming from diverse cultural and professional perspectives.
As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.
A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, to reach out with our hearts and touch the hearts of others. Through this effort we create Caring Communities where staff, residents, clients, and family members care for and about one another.
COVID Vaccines are available for CommuniCare employees. In conjunction with our pharmacy partners , we are currently offering free COVID vaccines to employees! You can protect yourself, your family, and your community from COVID by getting vaccinated at no charge.
Thank you for the application and stay safe!!!