Quality Improvement (QI) Specialist

Job Description

Job Description

At Wood River Health the Quality Improvement (QI) Specialist supports organizational quality improvement initiatives by collecting, analyzing, and distributing clinical outcomes data for internal and external reporting, as well as supporting internal and external audits. This role assists with routine quality-related activities, including data entry, electronic health record (EHR) review, and the administration of quality assurance and compliance processes.

The QI Specialist contributes to quality assurance audits and performance measurement related to health outcomes, in accordance with Uniform Data System (UDS), HEDIS, NCQA, Rhode Island Department of Health, and other internal organizational standards and goals. The position also supports the Director of Quality Improvement & Risk Management with risk management activities.

Essential duties include, but are not limited to:

Quality Measurement & Performance Initiatives

• Track, validate, and report organizational quality measures on an ongoing basis.
• Review, enter, and maintain accurate clinical and quality data in the electronic health record (EHR).
• Assist with identifying gaps in care and support initiatives to improve quality performance and health outcomes.
• Support providers and clinical teams with population health quality data.
• Maintain thorough and accurate documentation of all quality improvement (QI) activities.
• Participate in the design, implementation, and evaluation of Quality Improvement initiatives aligned with organizational goals.
• Conduct center-specific discussions with appropriate staff regarding identified deficiencies, performance improvement opportunities, and site-based initiatives.
• Assist with prenatal tracking in collaboration with WIC.
• Participate in Quality Management Committee meetings and related quality forums.

Audits, Reporting & Compliance

• Coordinate internal and external audits in accordance with a predetermined organizational audit schedule.
• Serve as the primary point of contact for external auditors, including scheduling audits and preparing required documentation and data.
• Participate in the annual Uniform Data System (UDS) submission process.
• Complete the annual cancer screening assessment and clinic report.
• Support quality department programs and initiatives, including but not limited to Health Helper and RIPCPC.
• Serve as a liaison to the Health Information Exchange (HIE).

Other Administrative Duties

• Manage the day-to-day incident reporting system.
• Collect, analyze, and report incident trends and findings to the Director of Quality and Risk Management.
• Coordinate the timely review, updating, approval, and distribution of organizational policies and procedures.
• Ensure policies are distributed to employees for acknowledgment, as appropriate.
• Conduct Quality Improvement orientation for new employees.
• Provide ongoing QI training, education, and support to clinical staff.
• Participate in professional development by attending programs workshops, in-services, assigned committees, department, and staff meetings.
• Maintain strict confidentiality in all matters
• Operate within the scope of the Health Information Portability and Accountability Act to safeguard the privacy of protected patient health information
• Enliven and support the mission, vision, and values of Wood River Health
• Adhere to organizational policies and procedures and Wood River Health Compliance Program Standards
• Performing other duties as assigned to meet business needs

The ideal candidate will have:

• Bachelor’s degree in Healthcare Administration or a closely related field
• Prior experience in a clinical or healthcare setting strongly preferred
• Demonstrated ability to collect, analyze, and interpret quality improvement data, with clear and concise summarization for reports and presentations
• Proficient in the use of electronic medical record (EMR) systems
• Strong written and verbal communication skills, with the ability to collaborate across interdisciplinary teams
• Ability to effectively use MS Office Suite, Internet, and email
• Cultural sensitivity necessary to work with a diverse patient and staff population

Wood River Health is an Equal Opportunity Employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, sexual orientation and gender identity), national origin, age, disability, genetic information, protected veteran status, or any other characteristic protected by federal law.