Total Quality Senior Specialist jobs in West Virginia

Basic Function:

The Resource Specialist is responsible for demonstrating project management and specialized skills in implementing assigned projects as part of organizational contract aims. This involves rapidly learning, assimilating and contributing to a wide array of Quality Insights projects in need of temporary or long-term management and/or assistance.  Primary activities include project support to quality improvement measures and other project-related objectives, collaborating with internal and external stakeholders, and participating in varied educational, data, and performance improvement strategies.  The Resource Specialist demonstrates leadership and/or assistance with the development, testing, and maintenance of clinical quality measures (CQM) reportable through an electronic health record (EHR) including familiarity with varied EHR coding/value sets such as CPT, HCPCS, ICD-9, ICD-10, SNOMED-CT, LOINC, RxNorm and others for use in electronic clinical quality measures (eCQMs). 

Organizational Relationships:

Reports to the Director, TBD
 

Role and Responsibilities:
 The essential functions include, but are not limited to, the following:

•             Assists in the development and maintenance of eCQMs. 

•             Assists with eCQM feasibility, reliability and validity testing with and internal and external stakeholders assisting with troubleshooting, product analysis, mitigation and report writing based on mapped testing protocols and evolving industry parameters. 

•             Assists with EHR value set discovery, usage and mitigation as they relate to CQM expert intent.

•             Works with internal Health Information Technology and Analytics staff develop measure concepts and flow diagram measure logic.

•             Participates and assists in coordination of multiple weekly stakeholder meetings related to measure development, maintenance and program deliverables. 

•             Establishes and maintains professional relationships with internal and external customers for assigned contract aims. 

•             Assists in the development of project standards, tools, protocols, processes, and knowledge-transfer mechanisms.

• Assists teams with the preparation of periodic and special reports on program status and contract deliverables.
• Serves as content expert on proposals for the acquisition of new business on an as needed basis.

•             Other duties as assigned.

Supervisory Responsibilities:

None

Skills / Professional Competencies Required:

•             Demonstrates ability to handle multiple projects and details simultaneously.  

•             Knowledge of full development and maintenance lifecycle of eCQMs.

• Demonstrates experience with varied EHR coding/value sets such as CPT, HCPCS, ICD-10, SNOMED-CT, LOINC, RxNorm and others for use in CQM development & maintenance.

• Knowledge of the Quality Data Model (QDM), Clinical Quality Language (CQL), Fast Healthcare Interoperability Resources (FHIR), Measure Authoring Tool (MAT), Bonnie, Measure Authoring Development Integrated Environment (MADiE), and the Value Set Authority Center (VSAC).

• Maintains comprehensive knowledge of current health care policies, practices and interventions through self-instruction and participation in available learning opportunities.

• Ability to work with minimal supervision and as part of a team.

•             Computer literate, with a high level of accuracy, and detail oriented.

Minimum Education/Training Required:

Bachelor’s degree in nursing, health information management/technology, or health informatics required.  A Master’s degree in nursing, health information management, health informatics or other relevant discipline from an accredited college or university is preferred.  

Minimum Experience Required:

Five years of full-time professional experience in a related healthcare field. Three years in a leadership/project-management role in a complex business or health care environment preferred.  Must have working EHR development and implementation, familiarity with XML and EHR programming fundamentals and knowledge of varied EHR coding/value sets such as CPT, HCPCS, ICD-9, ICD-10, SNOMED-CT, LOINC, RxNorm and others for use in eCQM development and maintenance. Experience with Oracle Cerner EHR a bonus.

Substitution(s):

Bachelor’s degree in statistics, public health, public administration, public policy, or a related field, with a minimum of three years of experience in electronic measures development, testing, and maintenance may be considered.

Licensure/Certification Requirements (including continuing education requirements):

If Registered Nurse (RN), must have valid RN license.  Project Management Certification preferred. 

Security Level:

Low