What are the responsibilities and job description for the Population Health and Quality Registered Nurse position at Wahiawa Center for Community Health?
The Quality RN will support Wahiawa Health’s clinical quality improvement, population health, patient education, and Value-Based Care initiatives.
Working closely with the Director of Clinical Operations, COO, providers, nurses, medical assistants, care management staff, and health plan partners, the Quality RN will help identify and close care gaps, improve clinical workflows, strengthen documentation, educate patients and staff, and improve organizational performance across key quality measures.
The position will have a particular focus on HEDIS, UDS, payer/insurance quality measures, preventive care, chronic disease management, population health, and Value-Based Care.
Essential Duties & Responsibilities
- Support organizational performance related to HEDIS, UDS, HRSA requirements, payer-specific quality measures, and Value-Based Care initiatives.
- Review EHR reports, patient registries, payer reports, and quality dashboards to identify patients with open care gaps.
- Conduct patient outreach and education to support completion of preventive screenings, chronic disease monitoring, immunizations, follow-up care, and other recommended services.
- Work directly with providers, nurses, medical assistants, and other clinical staff to improve completion of quality measures.
- Educate clinical staff regarding HEDIS, UDS, payer quality measures, documentation requirements, and recommended workflows.
- Help providers and clinical staff understand how documentation and day-to-day patient care affect organizational quality performance.
- Perform clinical chart reviews to identify missing documentation, outstanding care needs, and opportunities to close care gaps.
- Support quality initiatives involving diabetes, hypertension, cardiovascular disease, cancer screening, immunizations, maternal health, behavioral health integration, and other preventive and chronic care measures.
- Work with clinical teams to incorporate quality measures into routine patient visits and workflows.
- Collaborate with insurance plans and payer partners regarding quality initiatives, patient lists, care gaps, performance reports, and improvement opportunities.
- Review payer-specific quality requirements and help translate those requirements into practical clinical workflows.
- Coordinate with hospitals, specialists, laboratories, referral partners, and other healthcare organizations to obtain clinical documentation necessary to close care gaps.
- Support population health outreach and targeted interventions for high-risk and underserved patient populations.
- Identify barriers to care, including access, health literacy, transportation, social determinants of health, and continuity of care.
- Assist in developing and implementing quality improvement projects designed to improve clinical outcomes and organizational performance.
- Monitor quality performance trends and communicate opportunities for improvement to clinical and operational leadership.
- Assist with audits, chart reviews, data validation, and regulatory or payer quality reporting.
- Help develop and maintain policies, procedures, workflows, educational materials, and tools related to clinical quality improvement.
- Participate in Quality Improvement/Quality Assurance activities, clinical quality meetings, and interdisciplinary performance improvement initiatives.
- Maintain current knowledge of evolving FQHC/HRSA requirements, UDS measures, HEDIS measures, payer quality programs, and Value-Based Care initiatives.
- Perform other quality, population health, and clinical duties as assigned.
Required Qualifications
- Current and unrestricted Registered Nurse (RN) license in the State of Hawaiʻi.
- Graduate of an accredited nursing program.
- Strong clinical knowledge of primary care, preventive care, and chronic disease management.
- Strong patient education and communication skills.
- Ability to collaborate effectively with physicians, advanced practice providers, nurses, medical assistants, care managers, administrative staff, and leadership.
- Strong organizational, analytical, and problem-solving skills.
- Ability to review clinical information and use data to identify opportunities for improvement.
- Proficiency with electronic health records (EHRs) and clinical documentation.
- Ability to manage multiple priorities and work both independently and collaboratively.
Preferred Qualifications
- Experience in an FQHC, Community Health Center, primary care, ambulatory care, managed care, population health, or healthcare quality improvement environment.
- Knowledge of HEDIS and UDS quality measures.
- Experience with Value-Based Care and payer quality programs.
- Experience performing clinical chart reviews and identifying or closing care gaps.
- Familiarity with Medicaid, Medicare, and commercial health plan quality programs.
- Experience using quality dashboards, patient registries, payer portals, or population health tools.
- Experience educating clinical staff regarding quality measures, workflows, and documentation requirements.
- Quality improvement, population health, case management, or ambulatory nursing experience is highly desirable.
Pay: $40.00 - $48.00 per hour
Expected hours: 40.0 per week
Benefits:
- 403(b)
- Continuing education credits
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
Salary : $40 - $48