What are the responsibilities and job description for the Quality Assurance Specialist (RN / LPN) position at Southwest Montana Community Health Center?
Monday-Thursday 32 hours per week
Benefits-eligible
FLSA-non-exempt
$20.94-$30.37 DOQ and licensure
Position Summary
Under general supervision, the Quality Assurance Specialist (QAS) is responsible for various quality and improvement initiatives for the panel of patients covered under value-based health insurer contracts managed by the Southwest Montana Community Health Center. This includes management of the health of contract members and program development of this initiative which encompasses clinical quality, contract performance measures, patient satisfaction, regulatory requirements, and patient education. The QAS will work with a team of providers and administrators to focus on clinical quality, patient safety, patient experience, population health activities, contract compliance, and approaches to health improvement.
Position Requirements
Education: Graduate from an accredited college or university with a degree in Nursing.
License: Must possess a current Montana RN or LPN License in good standing and current certification in BLS.
Experience: A minimum of one year of case management experience or combination of relevant experience is required; experience in assisting patients through transitions on the care continuum; experience in managing psychosocial issues with patients and families; experience in collaborating with provider care teams and organizational leadership; federally qualified health center (FQHC) experience is desired; interest in data analysis.
Job Requirements
Immediate Supervisor: COO; in their absence, designee.
Physical Demands/Working Conditions
General office/clinic conditions are pleasant; good, clean working conditions where accident and hazards are negligible; requires short periods of moderate lifting, pushing or pulling objects up to twenty pounds. Clear diction and acute hearing are necessary for effective communication with the staff and public.
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.
About Southwest Montana Community Health Center
We are proud to partner with the Butte Job Service to assist job seekers. If you need free assistance preparing a professional resume, or preparing for an interview, please contact the Butte Job Service. They can be reached at 406-494-0300 or at www.montanaworks.gov. Their office is located at 2201 White Blvd., Butte, MT. Southwest Montana Community Health Center is a mission-driven, non-profit Federally Qualified Health Center (FQHC). FQHCs are community-based healthcare providers that receive funding from the Federal government to provide comprehensive primary care services in underserved areas. FQHCs provide care to all individuals, regardless of their ability to pay, and offer a sliding fee discount based on income. FQHCs must meet certain requirements to receive funding, such as providing services to medically underserved areas or populations, offering a comprehensive set of primary care services, and having a governing board that includes patients. Southwest Montana Community Health Center is a recognized National Committee for Quality Assurance (NCQA) Patient Centered Medical Home (PCMH). PCMH designation is gained by meeting certain standards set by the NCQA. These standards include providing comprehensive, coordinated care, using evidence-based practices, and engaging patients in their care. Community health centers that receive PCMH designation are recognized for providing high-quality, patient-centered care that improves health outcomes and reduces costs. PCMH is our model of primary care that emphasizes care coordination, communication, and patient engagement to improve the quality of care and patient outcomes. The PCMH model encourages providers to work as a team to coordinate and manage care for patients, provide timely access to care, and use evidence-based practices to improve outcomes. The PCMH model also emphasizes the importance of patient engagement, providing patients with the tools and resources they need to take an active role in their own health care. We opened our doors in 1986 under the name Butte-Silver Bow Primary Healthcare Clinic Inc. Our main clinic is in Butte, Montana, and we have locations in Dillon and Anaconda, Montana. We offer medical, dental, behavioral health, care management, pharmacy, and clinical pharmacy services to everyone. We accept most insurances and private-pay clients, as well as uninsured or underinsured clients. Our passion is to ensure that healthcare remains accessible and affordable to everyone. Our clinics care for more than 13,000 patients annually and employs more than 150 people in our various locations.
Benefits-eligible
FLSA-non-exempt
$20.94-$30.37 DOQ and licensure
Position Summary
Under general supervision, the Quality Assurance Specialist (QAS) is responsible for various quality and improvement initiatives for the panel of patients covered under value-based health insurer contracts managed by the Southwest Montana Community Health Center. This includes management of the health of contract members and program development of this initiative which encompasses clinical quality, contract performance measures, patient satisfaction, regulatory requirements, and patient education. The QAS will work with a team of providers and administrators to focus on clinical quality, patient safety, patient experience, population health activities, contract compliance, and approaches to health improvement.
Position Requirements
Education: Graduate from an accredited college or university with a degree in Nursing.
License: Must possess a current Montana RN or LPN License in good standing and current certification in BLS.
Experience: A minimum of one year of case management experience or combination of relevant experience is required; experience in assisting patients through transitions on the care continuum; experience in managing psychosocial issues with patients and families; experience in collaborating with provider care teams and organizational leadership; federally qualified health center (FQHC) experience is desired; interest in data analysis.
Job Requirements
- To perform this new position successfully, the individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill and/or ability required.
- Performance of all job functions and responsibilities and providing staff education are essential.
- Knowledge of private insurance, Medicaid, Medicare are desired as well as an understanding of reimbursement methodology and systems.
- An understanding of value-based contracts and their implementation into healthcare settings, particularly in federally qualified health centers.
- Use EHR and data aggregation tools to identify gaps in care.
- Actively participate in EHR chart hygiene to ensure data and reporting accuracy.
- Devise and develop healthcare processes to meet goals and objectives of value-based contract.
- Ability to communicate goals and objectives and contract progress to providers, care teams and administration is critical.
- Actively engage with providers and staff in identifying high-risk members and collaborate with providers and care teams on methods for improving patient participation and outcomes.
- Develop, communicate, and implement care plans in coordination with members, caregivers, providers, and care teams.
- Communicate assessment findings, care plan goals, interventions, and outcomes to providers. Ability to collaborate with peers, management, and other appropriate resources in complicated or unusual situations.
- Communicate with value-based contract members on care plan goals, interventions, and education to encourage better patient care outcomes.
- Work with Quality Assurance coordinator to analyze data from audit procedures to prepare and deliver audit reports to clinic administration and providers on meeting goals and objectives of value-based contracts.
- Assists with team members with the implementation of clinical models and interventions needed to meet goals and objectives of value-based contracts.
- Conduct internal audits and monitors contract compliance.
- Develops, implements, and evaluates quality assurance and quality improvement projects in conjunction with quality improvement coordinator.
- Participates in all clinical workgroups and patient improvement projects.
- Recommends policy and procedure changes to improve patient care and clinical outcomes.
- Collaborates with the health information technology site specialists to provide relevant reports.
- Demonstrate consistently strong ethics and sound judgment.
- Understanding of medical billing and coding.
- Ability to apply business principles including systems thinking to the healthcare environment, basic business principles including fiscal management, organizational dynamics and governance, strategic planning and marketing, information management, risk management and quality improvement.
- Skilled in developing and maintaining positive relationships and communicating effectively with internal and external customers
- Experience in conflict management and problem resolution.
- Computer skills: To perform this job successfully, the individual should have competence to use the internet, Microsoft office, and ability to learn electronic health records systems.
- Competent in understanding with racially and ethnically diverse populations.
- Knowledge of health record keeping.
- Understanding of PDSA performance model.
- Excellent oral and written communication skills.
- Ability to organize and prioritize tasks.
- Ability to work under pressure.
- Strong attention to detail and problem-solving skills.
- Ability to work independently and as a team member.
- Practices with the scope of education, training, and personal capabilities.
- Maintains confidentiality.
- Follows federal, state and local legal guidelines; follows license criteria when licensure applies.
- Maintains HIPAA & OSHA compliance.
- Reports any evidence of abuse or neglect to provider or appropriate official.
Immediate Supervisor: COO; in their absence, designee.
Physical Demands/Working Conditions
General office/clinic conditions are pleasant; good, clean working conditions where accident and hazards are negligible; requires short periods of moderate lifting, pushing or pulling objects up to twenty pounds. Clear diction and acute hearing are necessary for effective communication with the staff and public.
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.
About Southwest Montana Community Health Center
We are proud to partner with the Butte Job Service to assist job seekers. If you need free assistance preparing a professional resume, or preparing for an interview, please contact the Butte Job Service. They can be reached at 406-494-0300 or at www.montanaworks.gov. Their office is located at 2201 White Blvd., Butte, MT. Southwest Montana Community Health Center is a mission-driven, non-profit Federally Qualified Health Center (FQHC). FQHCs are community-based healthcare providers that receive funding from the Federal government to provide comprehensive primary care services in underserved areas. FQHCs provide care to all individuals, regardless of their ability to pay, and offer a sliding fee discount based on income. FQHCs must meet certain requirements to receive funding, such as providing services to medically underserved areas or populations, offering a comprehensive set of primary care services, and having a governing board that includes patients. Southwest Montana Community Health Center is a recognized National Committee for Quality Assurance (NCQA) Patient Centered Medical Home (PCMH). PCMH designation is gained by meeting certain standards set by the NCQA. These standards include providing comprehensive, coordinated care, using evidence-based practices, and engaging patients in their care. Community health centers that receive PCMH designation are recognized for providing high-quality, patient-centered care that improves health outcomes and reduces costs. PCMH is our model of primary care that emphasizes care coordination, communication, and patient engagement to improve the quality of care and patient outcomes. The PCMH model encourages providers to work as a team to coordinate and manage care for patients, provide timely access to care, and use evidence-based practices to improve outcomes. The PCMH model also emphasizes the importance of patient engagement, providing patients with the tools and resources they need to take an active role in their own health care. We opened our doors in 1986 under the name Butte-Silver Bow Primary Healthcare Clinic Inc. Our main clinic is in Butte, Montana, and we have locations in Dillon and Anaconda, Montana. We offer medical, dental, behavioral health, care management, pharmacy, and clinical pharmacy services to everyone. We accept most insurances and private-pay clients, as well as uninsured or underinsured clients. Our passion is to ensure that healthcare remains accessible and affordable to everyone. Our clinics care for more than 13,000 patients annually and employs more than 150 people in our various locations.
Salary : $20 - $30
