SPECIALITY RN- QUALITY/UTILIZATION REVIEW
Reports To: Director of Quality
Employee Type: EXEMPT X NON-EXEMPT
The Quality and Utilization Review Nurse is responsible for supporting quality and patient safety activities and initiatives, including medical records review, committee support, clinical data collection and reporting, process improvement, facilitation and implementation, keep a balance of the needs of a patient with the need to reinforce policies, keep costs reasonable, and ensure that patients are provided with medical treatment which is suited to their situations, and add a particular emphasis on patient safety across the district.
This job description is intended to identify some of the primary duties and responsibilities. MAYERS MEMORIAL HOSPITAL DISTRICT reserves the right to modify, supplement, delete or augment the duties and responsibilities specified in this position description, at MAYERS MEMORIAL HOSPITAL DISTRICT'S sole and absolute discretion.
1. Current CA RN license required
2. BSN preferred
3. Minimum of 3 years of clinical experience required; at least 2 years in the acute setting.
4. Previous experience in quality improvement methodology (PDSA, Lean, six Sigma) and/or accreditation preferred.
5. Previous experience with Utilization Management
1. Professional behavior is demonstrated, both when on duty and as a representative of MMHD outside of normal work hours.
2. Ability to work with others, at all levels within the organization, and collaborate effectively.
3. Above-average interpersonal, problem-solving, and written and oral communication skills.
4. A positive working relationship with patients, visitors, and facility staff is demonstrated.
5. Organizational ability and time management is demonstrated.
6. Produces deliverable products on time, within budget with minimal direction.
7. Demonstrates the ability to compile and organize data using Microsoft Office Applications. Ability to make appropriate recommendations or conclusions, given the data obtained.
8. Maintains an organized set of records, upon request, for the functions that are performed within the scope of this job.
9. Communicates appropriately and clearly to directors, managers, and coworkers.
10. Performs all assigned tasks accurately, to include proper spelling and grammar, reference materials, and minimal mathematical calculation.
11. Takes direction from others to include those employees of other departments with which he/she works on a temporary basis in accordance with the chain of command.
12. Maintains all information as confidential as appropriate, to include payroll, personnel information, and other information obtained during the course of performing job duties that is confidential.
13. Demonstrates ability to effectively use office machines in the performance of job functions.
14. Answers phone calls, assists public, and forwards appropriately if necessary and in a professional and friendly manner.
15. Other duties as assigned.
1. Assists the Director of Quality with quality improvement and safety activities and initiatives by gathering, entering, assessing and reporting clinical data and outcomes measures and developing tools and interventions with front line staff and physicians.
2. Creates flow charts for clinical processes as appropriate.
3. Use effective relationship management, coordination of services, resource management, education, patient advocacy, and related interventions to:
a. Promote improved quality of care and/or life
b. Promote cost effective medical outcomes
c. Prevent hospitalization when possible and appropriate
d. Promote decreased lengths of hospital stays
e. Prevent complications in patients under our care
f. Provide the continuity of care
g. Assure appropriate levels of care are received by patients
4. Assists with patient outreach and communications as needed.
5. Oversees projects as assigned utilizing continuous quality improvement, LEAN and project management methodologies.
6. Ensures adherence to quality standards to achieve project deliverables.
7. Performs patient care with valid licensure, within appropriate scope of practice when and where needed in the hospital.
8. Assists in the accreditation process by coordinating group activities, conducting on-site visits to assess compliance with accreditation standards, training staff in site audit procedures, and other tasks as identified by the accreditation team.
9. Serves as resource for staff education around accreditation standards and processes.
10. Assists with policy/standardized nursing procedure development and other appropriate learning or audit materials development in collaboration with various quality committees, physicians, nurses, staff and administrative leadership and performs other duties as assigned.
1. Adheres to dress code; appearance is neat and professional.
2. Completes annual education requirements if applicable.
3. Maintains regulatory requirements.
4. Wears identification while on duty.
5. Attends annual evaluation and participates actively in this process.
6. Reports to work on time and as scheduled; completes work in designated time.
7. Attends all meetings as appropriate.
8. Exhibits the mission, ethics and goals of Mayers Memorial Hospital District in the performance of job duties.
1. Willingness to work beyond normal working hours and in other positions temporarily when necessary.
2. Is involved with personnel, visitors and government agencies, etc., when necessary.
3. Must function independently, have personal integrity, have flexibility and the ability to work effectively with other personnel, clients and support agencies.
1. Sits, stands, bends, lifts, walks and moves intermittently during working hours.
2. Able to lift 20 lbs.
Position Type : Full Time
Shift : Day
Mayers Memorial Hospital District
43563 Highway 299 East; PO Box 459
Fall River Mills, Ca 96028