Talent.com
Organizational Quality Nurse Specialist

Organizational Quality Nurse Specialist

Hospice of MichiganSouthfield, Michigan, United States, 48034
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

Organizational Quality Nurse Specialist

Job Summary : Responsible for maintaining compliance with all State, Federal regulatory guidelines and third party payers; Accreditation standards and quality activities of the organization. Provides leadership and expertise to facilitate and support staff competency through best practice teaching, consultation, collaboration and the use of current knowledge, research and technology.

Essential Functions :

  • Ensures that there are processes in place to monitor and measure all activities related to quality assessment and performance improvement (QAPI).
  • Provides direction and coordination of quality improvement activities utilizing continuous quality improvement principles and methodologies. Provides education and training to organization personnel on the QAPI plan, and team development.
  • Performs clinical record review activities for data collection.
  • Compiles, analyzes, trends and reports quality data in the following areas : hospice & palliative care quality reporting, patient care, safety, risk management, infection control, outcomes and customer satisfaction.
  • Works collaboratively with nursing supervisors / managers / directors to assure documentation is complete and consistent with care and reflects legal requirements.
  • Promotes professional standards of care, compliance with regulatory requirements, third-party payor reimbursement models, and organization policies and procedures through use of performance improvement methodology.
  • Ensures complete responses to Additional Development Requests (ADRs), Comprehensive Error Rate Testing (CERT), Recovery Audit Contractor (RAC) etc., requests and participates in appeal processes.
  • Participates in the development and annual revision of Quality Assessment and Improvement Plans and Program Evaluation.
  • Participates in analyzing, developing, coordinating and implementing plans of correction for noted deficiencies.
  • Makes recommendations to the education committee for mandatory education related to accreditations and compliance topics.
  • Acts as a mentor and resource for staff with regard to performance improvement methodology, regulatory, educational and patient care issues.
  • Participates in the evaluation, development and revision of policies and procedures for hospice.
  • Participates on various committees related to Organizational Quality and Education.
  • Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal and professional networks.
  • Adheres to organizational Code of Conduct, policies, procedures, protocols and processes and all regulatory and legal requirements
  • Adheres to the C.A.R.E. Model of Service : courtesy, acknowledgement, response and empathy.

Qualifications :

  • Registered Nurse with a baccalaureate degree in nursing, preferably a Master’s Degree in a health-related discipline. Minimum three (3) years’ direct hospice experience may be considered in lieu of BSN degree.
  • Requires two to three years related quality and accreditation experience.
  • Current RN licensure in State of Michigan and maintain such licensure in accordance with applicable laws and regulations and perform within the scope specified.
  • Extensive knowledge of Hospice regulations and standards preferred.
  • Excellent written, verbal and interpersonal skills necessary to interact with a wide variety of staff.
  • Is self-directed and able to work with minimal supervision.
  • Requires knowledge of quality assessment and utilization review functions, principles and practices.
  • Theoretical and practical knowledge of principles of adult learning and ability to develop and present educational programs.
  • Quantitative, analytical and computer skills to collect, analyze, display and present data.
  • The physical and sensory demands of the position include : vision, effective speech and hearing for extensive telephone contact; repetitive motion; traveling; driving or riding in motor vehicle; standing, sitting, walking, bending, reaching, and stretching; lifting up to forty five (45) pounds unassisted and the ability to assist in lifting patients using appropriate lifting techniques and / or devices.
  • Must be able to work variable hours / shifts and / or days, including weekends. Must have ability to occasionally work extended days.
  • Must be eligible to work in the United States.
  • PIdb088bf352ac-30511-37119807

    serp_jobs.job_alerts.create_a_job

    Quality Specialist • Southfield, Michigan, United States, 48034

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    Registered Nurse Quality Assurance

    Registered Nurse Quality Assurance

    VirtualVocationsWarren, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Quality Assurance Registered Nurse (Telehealth Support) - Full-Time.Key Responsibilities Lead and support quality improvement initiatives across clinical programs Iden...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    California Licensed Review Nurse

    California Licensed Review Nurse

    VirtualVocationsWarren, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Pre-Service Review Nurse RN to work remotely in the Pacific or Mountain Time Zones.Key Responsibilities Conduct utilization management, including Prior Authorization Re...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_hour
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    South Carolina Licensed RN Reviewer

    South Carolina Licensed RN Reviewer

    VirtualVocationsWarren, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for an RN Medical Reviewer II to perform medical reviews and support medical claims processing.Key Responsibilities Conduct medical claim reviews for complex services and det...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Clinical and Statistical Data Programmer

    Clinical and Statistical Data Programmer

    Zoetis, IncDetroit, MI, United States
    serp_jobs.job_card.full_time
    Clinical and Statistical Data Programmer.Statistics and Data Management, Automation and Data Sciences.Veterinary Medicine Research & Development (VMRD). The successful applicant embodies Zoetis' Cor...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    RN Clinical Appeals Reviewer

    RN Clinical Appeals Reviewer

    VirtualVocationsWarren, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for an IBR Clinical Appeals Reviewer - Remote.Key Responsibilities Analyze and respond to IBR Appeals inquiries Perform medical record reviews and prepare written appeals C...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Certified Coder Physician

    Certified Coder Physician

    VirtualVocationsDetroit, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Coder Physician.Key Responsibilities Abstract, code, sequence, and interpret clinical information from various medical records Assign correct principal and secondary d...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Healthcare Implementation Analyst

    Healthcare Implementation Analyst

    VirtualVocationsWarren, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for an Implementation Business Analyst to create business requirements and liaise between Business Operations and Technology IT teams for new projects and improvements.Key Resp...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Oregon Licensed Clinical Nurse Auditor

    Oregon Licensed Clinical Nurse Auditor

    VirtualVocationsDetroit, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Clinical Nurse Auditor, HEDIS who will conduct clinical quality audits and improve quality within the healthcare network. Key Responsibilities Conduct clinical quality a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    Quality Assurance InteRegistered Nurse – Summer 2026 - Urgently Hiring!

    Quality Assurance InteRegistered Nurse – Summer 2026 - Urgently Hiring!

    HenkelWarren, MI, United States
    serp_jobs.job_card.full_time
    At Henkel, you’ll be part of an organization that’s shaping the future through innovation, sustainability and collaboration. With our trusted brands like Persil®, ‘all®, Loctite®, Snuggle®, and Schw...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Assistant Director of Nursing (ADON)

    Assistant Director of Nursing (ADON)

    Regency at Whitmore LakeWHITMORE LAKE, Michigan, United States
    serp_jobs.job_card.full_time
    Are you a Registered Nurse (RN) looking for a leadership opportunity with a growing organization? We have an exceptional opportunity for an Assistant Director of Nursing (ADON) to join our team at ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    Quality Assurance InteRegistered Nurse – Summer 2026 - Now Hiring!

    Quality Assurance InteRegistered Nurse – Summer 2026 - Now Hiring!

    HenkelWarren, MI, United States
    serp_jobs.job_card.full_time
    At Henkel, you’ll be part of an organization that’s shaping the future through innovation, sustainability and collaboration. With our trusted brands like Persil®, ‘all®, Loctite®, Snuggle®, and Schw...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Clinical Documentation Integrity Lead

    Clinical Documentation Integrity Lead

    VirtualVocationsDetroit, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for a Clinical Documentation Integrity Lead - Service Line (Remote).Key Responsibilities Manage relationships between CDI and assigned service lines, collaborating with physi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Clinical Coordinator High Risk Full Time Days

    Clinical Coordinator High Risk Full Time Days

    DMC Harper University / Hutzel Women's HospitalDetroit, MI, US
    serp_jobs.job_card.full_time
    Up to $10,000 Sign on Bonus, based on relevant experience • •.DMC Harper University Hospital.A specialty referral hospital, Harper has established Centers of Excellence in neurosciences, bariatric su...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Licensed RN Clinical Appeals Reviewer

    Licensed RN Clinical Appeals Reviewer

    VirtualVocationsWarren, Michigan, United States
    serp_jobs.job_card.full_time
    A company is looking for an IBR Clinical Appeals Reviewer who will analyze and respond to client and hospital claim review appeal inquiries. Key Responsibilities : Analyze scope and resolution of I...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    2026 Summer Healthcare Operations & Value Based Care Consulting Intern Southfield

    2026 Summer Healthcare Operations & Value Based Care Consulting Intern Southfield

    Plante MoranSouthfield, MI, United States
    serp_jobs.job_card.full_time
    Our "we-care" culture is more than just a motto; it's a promise.From day one, we prioritize your growth, well-being, and success. You can count on us to support your career journey and help you achi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Clinical Coordinator - Contract

    Clinical Coordinator - Contract

    Macomb County Community Mental HealthClinton Township, MI, US
    serp_jobs.job_card.full_time
    Under direction provides overall clinical coordination and guidance for the Macomb County Community Mental Health (MCCMH) system. Works with the Waiver Support Application (WSA) to process requireme...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Clinical Manager

    Clinical Manager

    Quality Care HospiceFranklin, MI, US
    serp_jobs.job_card.full_time
    Responsible as a member of the interdisciplinary and clinical management teams to the.Director for the implementation, delivery, coordination and supervision of Hospice services delivered by respec...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    Quality Assurance InteRegistered Nurse – Summer 2026

    Quality Assurance InteRegistered Nurse – Summer 2026

    HenkelWarren, MI, United States
    serp_jobs.job_card.full_time
    At Henkel, you’ll be part of an organization that’s shaping the future through innovation, sustainability and collaboration. With our trusted brands like Persil®, ‘all®, Loctite®, Snuggle®, and Schw...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30