About the Role
PQMS is seeking a highly experienced Healthcare Quality Registered Nurse with a CPHQ certification to join our team. The ideal candidate will have at least 5 years of experience in healthcare quality management, specifically in reporting Value-Based Measures to CMS.
Key Responsibilities
Quality Measure Reporting:Â Collect, validate, and report quality measures to CMS, including CMS Value-Based Programs. Ensure timely and accurate data submission in compliance with CMS, and monitor and implement changes in reporting guidelines.
Quality Improvement:Â Identify opportunities for quality improvement based on data analysis and regulatory requirements, and develop and implement quality improvement initiatives. Monitor their effectiveness, promote best practices, and collaborate with healthcare teams to ensure adherence to quality standards.
Data Analysis and Interpretation:Â Analyze quality data to identify trends and areas for improvement, and prepare and present reports on quality metrics to stakeholders. Use data analysis tools and quality management software to support decision-making and strategic planning.
Compliance and Auditing:Â Ensure compliance with relevant quality standards, regulations, and accreditation requirements. Conduct regular audits of clinical practices and documentation, and implement corrective actions based on audit findings.
Training and Education:Â Educate and train healthcare staff on quality measures, reporting requirements, and improvement processes, including CMS Value-Based Programs. Develop educational materials, conduct workshops or seminars, and foster a culture of continuous learning and quality improvement.
Stakeholder Collaboration:Â Collaborate with internal and external stakeholders to enhance quality improvement efforts, and engage in strategic planning and decision-making processes. Provide support and guidance to healthcare teams to ensure successful implementation of quality initiatives.
Continuous Improvement:Â Foster a culture of continuous quality improvement within the organization and encourage the adoption of best practices and evidence-based approaches. Regularly review and update quality improvement strategies to align with evolving standards and regulatory requirements.
Qualifications
Registered Nurse (RN) with an active license.
Certified Professional in Healthcare Quality (CPHQ) certification.
Minimum of 5 years of experience in healthcare quality management and reporting to CMS, including CMS Value-Based Measures.
Strong understanding of CMS quality measures.
Excellent analytical, organizational, and communication skills.
Proficiency in data analysis tools and quality management software.
Experience with electronic health records (EHR) systems.
Knowledge of Lean or Six Sigma methodologies.
Familiarity with other regulatory bodies and their quality reporting requirements.
Ability to travel up to 75% of the time.