Senior Clinical Outcomes Specialist - Quality (Medical Center)

At Houston Methodist, the Senior Clinical Outcomes Specialist is responsible for supporting regulatory and/or accreditation quality reporting requirements, internal quality initiatives, clinical outcomes processes, and clinical benchmarking endeavors of the entity. This includes concurrent and/or retrospective data abstraction, data management, data analysis, report generation, results presentation and dissemination, and education of medical staff, entity staff and management. In addition, the Senior Clinical Outcomes Specialist is also responsible for supporting department and entity performance improvement initiatives/projects. Also supports management with education, coaching, and mentoring of team members, as well as orientation of new employees to the team.

FLSA STATUS
Exempt

QUALIFICATIONS

EDUCATION

• Bachelor of Science in Nursing required
• Master’s degree in nursing or any related field preferred

EXPERIENCE

• Five years of direct patient care in acute care hospital or ambulatory environment required
• Two years in data management for clinical benchmarking or clinical registry

LICENSES AND CERTIFICATIONS
Required

• RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency) and
• Must have CPHQ from NAHQ or CPPS from CBPPS

SKILLS AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
• Ability to effectively communicate with patients, physicians, family members, and co-workers in a manner consistent with a customer service focus and application of positive language principles
• Ability to review medical information from multiple computer sources, abstract pertinent information, and assimilate findings based upon defined measurement guidelines
• Detail oriented, focused, and organized amidst competing priorities and deadlines
• Ability to coach, mentor, and teach
• Intermediate computer and analytical skills
• Skill in general use of Excel spreadsheet, relational database, presentation and word-processing software and the Internet; proficiency with MS Word, Excel, PowerPoint, and Outlook essential for success in this position
• Excellent time management and organizational skills
• Ability to work independently and with teams
• General knowledge of performance improvement methodologies

ESSENTIAL FUNCTIONS

PEOPLE ESSENTIAL FUNCTIONS

• Communicates and disseminates timely data analyses and findings to management and appropriate entity and/or medical staff committees.
• Communicates timely and relevant feedback to team, management, entity, and/or medical staff as it pertains to assignment, errors in coding, performance/process improvement initiatives, ongoing projects and other related issues; follows-up on and closes the loop of each communication to ensure timely resolution or escalation if necessary.
• Adheres to agreed upon escalation process for communication within the department, entity and/or medical staff.

SERVICE ESSENTIAL FUNCTIONS

• Acts as a role model for team members, providing just-in-time education, coaching, and mentoring; coordinates education and in-service trainings for team and orientation of new employees; develops education/training modules, presentations, and other tools to facilitate team learning and development of competencies.
• Supports Department with data abstraction for regulatory and/or accreditation requirements; Leads and/or actively participates in performance/process improvement initiatives/projects at the service line, entity, and/or system level.
• Interprets and analyzes data to determine trends, identify potential causative factors and opportunities for improvement; incorporates analyses into routine monthly or ad hoc reports, using statistical tools/graphic models appropriate for data and intended audience; presents the information to various committee or performance improvement teams.
• Serves as a resource, consultant, and expert for assigned registry or measure sets for the Department, entity leadership, and staff; develops educational tools and provides education support on registry or accreditation requirements, national society registry or clinical guidelines, and any new requirements or changes to entity staff, service lines, or committees.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Accurately abstracts data through concurrent and/or retrospective medical record review; organizes and inputs data into appropriate database in accordance with specifications manual or coding instructions; adheres to volume requirement and submission deadlines; if required, meets registry volume requirement for follow-up phone calls to clinics, patients or families within the required timeframe.
• Clarifies interpretation of specifications manual/coding instructions/abstraction guidelines with appropriate registry or measure set support team and disseminates information to team, entity, and/or medical staff as needed.
• Reviews and validates accuracy and completeness of abstracted data on an established and agreed upon schedule and prior to submission; adheres to established department internal and external validation process to ensure quality, accuracy, and integrity of data.
• Supports RCAA/FMEA process as requested when patient outcomes suggest possible system failures; actively participates in performance/process improvement initiatives/projects when expertise is needed in response to system failures identified.

FINANCE ESSENTIAL FUNCTIONS

• Manages department resources and assignment effectively and efficiently as evidenced by prudent use of office supplies, timely data abstraction, data entry, and data submission.
• Reports case reviews with incorrect diagnosis or procedure code and refers cases to Coding team for review and re-coding as appropriate.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• Maintains knowledge of guidelines governing data abstraction, regulatory, and accreditation requirements; stays current with clinical knowledge for specialty area by participating in internal or external educational opportunities.
• Makes recommendations to team, department, entity, and system committees on how to improve processes and performance based on registry or clinical guidelines.

SUPPLEMENTAL REQUIREMENTS
WORK ATTIRE

• Uniform: No
• Scrubs: No
• Business professional: Yes
• Other (department approved): No

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.

• On Call* No

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area No
• May require travel outside Houston Metropolitan area Yes

QUALIFICATIONS

EDUCATION

• Bachelor of Science in Nursing required
• Master’s degree in nursing or any related field preferred

EXPERIENCE

• Five years of direct patient care in acute care hospital or ambulatory environment required
• Two years in data management for clinical benchmarking or clinical registry

LICENSES AND CERTIFICATIONS
Required

• RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency) and
• Must have CPHQ from NAHQ or CPPS from CBPPS