Coordinator, Quality Assurance Rn - (Remote)

Description:

Job Summary:

Works under the MOC Clinical Contact Center (CCC) Support Nursing and Clinical Optimization structure to provide shared service support and improvement in our clinical telephone advice practice, service quality and regulatory compliance. The Quality Assurance RN Coordinator is responsible for monitoring and documenting our clinical telephone teams call quality in support of the department quality goals and initiatives. The QA coordinator participates in the design of all quality monitoring formats and quality standards. The QA Coordinator devises, analyzes and publicizes quality data in dashboards to include the consolidation of quality score data from the call center for ongoing progress reporting to local and national entities. The Quality Assurance Coordinator works with the MOC CCC Leadership Team, to identify, communicate and respond to opportunities to standardize and improve quality assurance work. The QA Coordinator is primarily responsible for assuring that Clinical Telephone Advice staff receives regular, timely and consistent quality reviews utilizing system tools and processes.

Essential Responsibilities:

• Monitors Calls and Researches Errors/Concerns: Monitors and researches phone calls with members to ensure Telephone Advice Nurses and other clinical contact support teams are in compliance with KP policies and expectations. Provides trend data to site management team based on call monitoring. Provides actionable data to various internal support groups as needed. Facilitates call calibration sessions. Determines and classifies root causes for dissatisfaction and recommends corrective measures and process improvement that increase overall satisfaction and quality. Results from evaluations are communicated to the leadership team with action plan. Identifies trends and patterns where additional training may be necessary. Serve as a role model and information resource for staff, Charge Nurses, Leads and department management by facilitating clinical quality and service excellence in all member/member interactions.
• Sets Clinical Call Quality Standards: Participates and facilitates the development and improvement of clinical call monitoring formats and quality standards. Performs recorded call monitoring and provides performance data to management teams. Utilizes quality monitoring program to compile and track performance at an individual, functional, and department levels. S/he will maintain awareness of resource material and represent Clinical Contact Center for constant review and update of resources for Advice Nurses. Calibrates with other quality assurance monitors according to scheduling processes. Acts as a mentor in teaching KP policies/procedures, department services, Service Agreements and skills necessary to interact with all members.
• Collects, Maintains and Reports on Relevant Data: Uses quality monitoring data management system to compile and track performance at individual level. Assists in data gathering to identify and resolve process gaps to promote efficiency and create proposals for changes which can create quality outcomes, efficiencies and/or streamline processes. Maintains database and spreadsheets to measure and track departmental metrics. Will meet monthly, or as needed, with CCC Leadership to review quality assurance data, schedules, progress and calibration and to engage in developing methods for improving quality outcomes. Administers and maintains NICE system for verbal/desktop monitoring of quality and accuracy of telephone interactions with members.

Basic Qualifications:

Experience

• Minimum three (3) years of experience in acute care nursing or in a clinical contact center as a RN, with at least one (1) year of experience performing Quality Assurance in a call center environment OR one (1) year employment in the Clinical Contact Center department with demonstrated high level skills applicable to support improvement in clinical practice, service quality and regulatory compliance

Education

• Bachelors degree OR four (4) years of experience in a directly related field.
• High School Diploma or General Education Development (GED) required.

License, Certification, Registration

• Registered Nurse License (Washington) OR Registered Nurse License (Colorado) OR Registered Nurse License (Oregon) OR Registered Professional Nurse License (Georgia) OR Registered Nurse License (California)
• Basic Life Support required at hire

Additional Requirements:

• Exemplary communication and negotiation skills.
• Demonstrated ability to learn and communicate complex information quickly and in various formats.
• Minimum typing speed of 40 words/minute.
• High-level of competency use of PC in Windows environment.
• Leadership skills in staff development.
• Ability to work independently and exercise sound judgment in decision-making without immediate supervision.
• Excellent time management, organization and prioritization skills.

Preferred Qualifications:

• Knowledge of Federal, State and Medicare regulations and mandates pertinent to Health Maintenance Organizations, delivery of medical care and insurance.
• Minimum two (2) years of experience in a Training, Lead or QA role.
• Bachelors degree in a healthcare related field.
• Experience using the NICE Quality Monitoring System.
• Experience in hardware/software support, or demonstrated ability to quickly become proficient in a software administration position.
• Experience in developing, tracking and reporting measurements to all levels of an organization.
• Working knowledge of Windows and Kaiser computer systems, including but not limited to NICE, HealthConnect, LOTUS, Sametime, Working knowledge of a variety of web-based systems.