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Wexford Health’s Quality Management and Corporate Compliance department is made up of certified clinical auditors, licensed nurses and other industry experts who focus on quality improvement/assurance, accreditation and clinical training.

Quality Nurse Consultant Job



Job Number: 78379642513

Location: Pittsburgh, PA

Date Posted: 7-7-2017

Wexford Health Sources, one of the nation's leading innovative correctional health care companies, provides clients with experienced management and technologically advanced services, combined with programs that control costs while ensuring quality.  For nearly two decades, Wexford Health has consistently delivered proven staffing expertise and a full range of medical, behavioral health, pharmacy, utilization management, provider contracting, claims processing, and quality management services.

At Wexford Health our philosophy is that health care should not be considered a luxury for anyone.  We simply care for those in need and the corrections environment is our venue.

Wexford Health has an exceptional opportunity for a full-time Quality Nurse Consultant to join our team of healthcare professionals. This position is based out of a home office and involves extensive travel.

We’re proud to offer a competitive benefits package including:

  • Annual review with performance increase
  • Generous paid-time off program that combines vacation and sick leave
  • Paid holidays
  • Comprehensive health insurance through Blue Cross Blue Shield
  • Dental and Vision insurance
  • 401(k) retirement saving plans
  • Company-paid short-term disability
  • Healthcare and dependent care spending account

POSITION SUMMARY

The Quality Nurse Consultant is responsible for monitoring the nursing department’s compliance with all federal and state legislation (MCCS, ACA, NCCHC, Programs, etc.), accreditation requirements, Wexford Health policies and procedures, and current contract requirements.  The Quality Nurse Consultant provides guidance and consultation to leadership on any processes, policies, or practices not in compliance.  The Consultant also provides leadership, consultation, and support in the development of a culture of quality and continuous improvement.

JOB RELATIONS

Supervision received

  • Direct supervision from the Director, Quality Management

Supervision exercised

  • None

Relationships

  • Inter-relates and works effectively with medical and nursing staff, security staff at all levels, administrative and support staff, WHS regional staff, and WHS corporate staff, as required.

 

ESSENTIAL DUTIES/RESPONSIBILITIES

  • Works with each contract’s Statewide CQI Coordinator, Statewide Director of Nursing and Regional Director of Nursing (or equivalent positions) to monitor the nursing department’s compliance with regulatory and contract requirements, per the state-wide Continuous Quality Improvement (CQI) program, and is in alignment with program evaluation findings and goals.
  • Completes contract compliance audits and provides reports to supervisory personnel.
  • Provides recommendations to the leadership team and participates in decision-making on action plans, education, outcome studies, and utilization of services as it relates to the CQI process.
  • Works closely with each contract’s Regional management team and clinical site leadership to maintain CQI standards and measures and to design and implement effective processes and programs to improve quality of care and ensure compliance, including high volume, high risk areas including but not limited to utilization of on-site and off-site specialties.
  • Assists in the development and training of clinical policies/procedures related to JCAHO, NCQA standards or similar health industry standards.
  • Prepares for and presents at the quarterly Corporate CQI Meeting as requested.
  • Monitors Chronic Care and Intake process for compliance with policy and contract requirements.
  • Reviews and audits documentation in the medical record (whether electronic or paper) for tracking and trending information.
  • Ensures policies and procedures comply with regulatory and contract requirements related to CQI process and outcome monitoring and evaluation of services and program.
  • Collaborates with the Regional leadership team to assess performance monitoring and implement improvement plans, and to ensure accountability, feedback loops and monitoring systems.  Preforms on site audits as indicated to ensure ongoing compliance.
  • Collects and analyzes data to identify trends and patterns related to areas of concern.
  • Maintains strong relationships with leadership and nursing staff by to ensure the quality of activities and projects leads to ongoing improvement.
  • Provides oversight of grievances and complaints for identified trends and improvement strategies.
  • Works closely with Regional leadership team regarding opportunities to improve selected aspects of clinical care and the specific actions needed in order to achieve goals for improvement on selected clinical quality measures.
  • Assist in compiling and completing monthly CQI summary.
  • Facilitates the tracking and compiling of wound data, Infection Control date, and inpatient admissions from facility infirmaries as requested.
  • Provides assistance to sites with audit (NCCHC, ACA, MCCS, Programs, and Quarterly Scorecard assessments).  Provides assistance by way of troubleshooting for a variety of nursing related issues.
  • Participates in pertinent professional education to maintain current knowledge of best improvement practices.
  • Complies with Wexford Health’s and correctional facility’s policies and procedures, including all safety and security regulations. 
  • Maintains confidentiality of inmate records and complies with HIPAA and PHI regulations. 

The duties and responsibilities outlined herein are for payroll purposes only; employees may be assigned other duties as required.

PHYSICAL DEMANDS

The physical demands that are described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential duties are routinely performed in a general office and clinical environment in a correctional facility.  Duties may require work in at a station/desk and entail paperwork, use of computers, fax machines, copiers, and other business machines and medical equipment.  Essential duties may require the following physical demands: the strength to lift and carry material weighing up to 30 pounds; vision to read printed materials and computer screen; walking; reaching; carrying; stooping; bending; squatting; prolonged sitting; handling (hand movement); hearing and speech to communicate in person and over the telephone; intellectual skills including short and long term memory, abstract reasoning, and decision making.

Must be able to ambulate throughout the facility for extended periods of time; specific vision abilities required by this job include close vision and distant vision, color vision, peripheral vision, depth perception, and the ability to adjust focus; must be able to clearly communicate orally and via written and typed correspondence and notes using various forms, records, charts, and electronic media.

Employee may be exposed to a challenging environment, which may include exposure to Bloodborne and Airborne Pathogens and loud noises.

ENVIRONMENTAL CONDITIONS

 

Office

Standard medical setting in a correctional facility, which includes daily interfacing with inmates, correctional staff, and health care personnel.

Temperature extremes may be encountered while moving throughout the facility outdoors and indoors in buildings without air conditioning.

Travel

Frequent Travel is required

 


EDUCATION/EXPERIENCE REQUIREMENTS

Licensing

Current unrestricted Registered Nurse license required

Certification

Current CPR Certification

Quality Improvement Certification, preferred

Education

Bachelor’s degree required.   BSN /MSN preferred

Preferred experience

  • Five-seven (5-7) years of quality improvement experience and 3-5 years of nursing experience.
  • Correctional experience preferred
  • Fundamental knowledge and skill in utilization of computer applications.

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