Cardiac Process Improvement and Project Specialist at Bryan Health in Lincoln, Nebraska

Job Description:

Bryan Health * Bryan Medical CenterLincoln, NENursingFull-time, Day shift, 8am-5pmReq # 22403

GENERAL SUMMARY:

The CVS Process Improvement and Project Specialist provides information for and supports the organization's Cardiac and Vascular Services (CVS) Strategic Plan, Quality Plan and designated operational and clinical priorities for care directly impacting the organization's reimbursement, collected revenue and patient outcomes. Oversees performance process improvement initiatives for the Cardiovascular Service Line (CVSL). Facilitates the analysis and reporting of data which is abstracted from medical records, entered into appropriate databases and reported to medical staff, CVS clinical and ancillary staff, the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission. In addition, facilitates improvement in the overall quality, completeness and accuracy of medical records.

PRINCIPAL JOB FUNCTIONS:

1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.

2. *Maintains current knowledge of CMS program measures for payment determinations and Joint Commission requirements to ensure that accreditation and certification requirements specific to the cardiac service line are addressed on an ongoing basis.

3. *Interprets and clarifies definitions of needed data; utilizes data collection techniques and maintains a specified level of accuracy with data collection.

4. *Coordinates the development and implementation of spreadsheet/database systems for quality improvement functions.

5. *Conducts chart reviews and special audits in accordance with performance improvement.

6. *Ensures that all appropriate data are entered into respective databases, verifying accuracy and completeness of data by reviewing system administrative and management reports, conducting inter-rater reliability reviews and reviewing CMS validation results.

7. *Coordinates the design of reports and graphs that accurately and efficiently represent process and outcomes data and assures data integrity.

8. *Analyzes and interprets visual and summarized data findings; evaluates findings in comparison to current and past trends; benchmarks data from other hospitals and standardized information from literature sources.

9. *Represents the CVSL on teams for organization-wide process and performance improvement; facilitates teams as indicated or requested.

10. *Collaborates in the selection, development and monitoring of performance indicators for the CVSL.

11. *Regularly identifies target patient populations and intervenes with healthcare providers when patient care is noncompliant with required indicators; generates regular reports for healthcare teams and management.

12. *Conducts mortality reviews and completes brief case reviews for meeting presentations to healthcare team.

13. *Reports data to appropriate internal and external customers, including medical staff, clinical and ancillary staff, CMS and the Joint Commission.

14. *Performs patient admission and continued stay reviews for specific patient populations utilizing clinical documentation and coding guidelines.

15. *Maximizes reimbursement by ensuring physician documentation accurately reflects severity of illness and the intensity of service.

16. *Educates internal customers on clinical documentation opportunities, in addition to opportunities involving coding and reimbursement issues.

17. *Acts as a liaison between Clinical Quality Improvement, CVS, HIM and external data customer/vendors; contacts appropriate individuals with departmental questions/issues related to project work.

EDUCATION AND EXPERIENCE:

Nebraska licensure/degree in Nursing or related clinical allied health profession required. Nebraska licensure as a Registered Nurse with Bachelor's degree required. Minimum of three (3) years clinical experience in cardiovascular area required.

OTHER CREDENTIALS / CERTIFICATIONS:

Basic Life Support (CPR) certification required.

Equal opportunityAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status, or disability status. Bryan Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

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