Job Summary

Responsible for the coordination of Quality Improvement activities and projects in support of the Health Plan.

Job Duties

• Works collaboratively as an educator and educational resource with operational site managers and other regional personnel to develop and encourage proactive processes to ensure optimal compliance with regulatory and accrediting body standards.
• Assists with coordinating the process in the region to ensure completion of medical record audits within the specified time frames as defined by internal workgroups or external regulating bodies.
• Researches medical care reviews.
• Serves as a regional resource on quality improvement policy and procedures and also education on process improvement and application of the results of studies.
• Serves as a facilitator with contracted hospitals in the region to support a full understanding of the process.
• Reviews medical records for provider compliance with minimum documentation and patient safety standards.
• Acts as a resource to providers sharing information for improvement and directing development of an action plan when a medical record and patient safety review re-audit is necessary.
• Participates with the the Health Plan Regional Medical Director in areas of medical care concerns, education, opportunities for the improvement of quality and initiation of regional activities as appropriate.
• Educates primary care physicians and primary care site personnel regarding specific quality standards and the support available to them through the Health Plan.
• Tracks member compliance and executes appropriate intervention for non-compliant members, including direct contact with members, primary care physicians and others as needed.
• Participates in regional meetings to develop innovative programs to maximize compliance rates for members and assures optimal performance standards.

Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Position Details

• Hours: 8a to 5p
• Travel: Yes, less than 25% for orientation, training, meetings, etc
• Work location: This position is work for home. Must be a PA resident and able to travel as needed
• Required experience: BSN with 5 years of RN experience

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At Geisinger, the caring that we provide to our patients and members also extends to you and your family. Our competitive compensation and benefits package helps you and your loved ones stay healthy, meet your financial goals and thrive professionally and personally.

• Benefits: Geisinger offers a comprehensive suite of healthcare benefits, including medical, prescription drug, vision, dental coverage and 401K. And with our healthcare benefits, you'll also receive care from one of the top innovative healthcare systems in the country. Our suite of benefits supports you and your family in a variety of ways, including coverage for same-sex or opposite-sex spouses, domestic partners and their children and stepchildren.
• Paid Time Off: Our generous paid-time-off packages allow you to take the time you need to travel, rest, and care for and reconnect with friends and family. We also offer paid military and parental leave.
• Diversity and Inclusion: We strive to create an environment where our patients, health plan members and employees can be their most authentic selves. Join one of our many Employee Resource Groups (ERGs). ERGs provide opportunities for all Geisinger employees to build internal and external networks and further develop professionally. ERGs are formed around common identities but are open to all employees.
• Tuition Assistance: Up to $5,000 tuition reimbursement: We offer tuition reimbursement towards both undergraduate and graduate degrees.(Part time and Full Time Positions only)
• Retirement: We contribute 5% of your salary to your retirement plan and offer auto-enrollment to make saving convenient for you.

Education

Bachelor's Degree-Nursing (Required)

Experience

Minimum of 5 years-Clinical (Required)

Certification(s) and License(s)

Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic Life Support Certification - Default Issuing Body

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.