The Quality Assurance Nurse Auditor position is responsible for managing the quality review process of advice nurses and follow-up on both internal and external customer concerns. This position will be responsible of ensuring appropriate advice guidelines are being utilized and documentation meets established standards consistently to support department and regional nursing and compliance standards. Data entry of quality concerns into the Call Centers quality improvement database. Results of data will be reported monthly to the Advice Nurse Call Center Operations Managers and Director. And as call volume dictates, this position will be responsible for assisting in providing high quality telephone service to Kaiser Permanente members via the automated call distribution system.The person in this position supports the Advice Nurse Call Centers in the area of Quality Improvement in the clinical area. This will include but is not limited to researching quality concerns and providing results to management and senior leaders. Employee will review calls and documentation and provide feedback on individuals pertaining to their adherence to quality standards, appointment booking guidelines and other such appropriate job aids. He/she facilitates formal complaint investigations per NCQA compliance guidelines. The Quality Assurance Nurse Auditor will serve as an advisor to management, supervisors, and trainers to identify process, systems and training needs and to aid in improving quality.
Essential Functions:
- Audits advice calls by regularly listening/recording calls for quality checks and teaching purposes and, using the established quality tool to ensure adequate and appropriate documentation.
- Responsible for coaching and mentoring the advice nurses in the use of communicating with care techniques. Assist in 1:1 coaching and mentoring in development opportunities.
- Generate monthly advice QI reports to submit to Clinical Operations Manager.
- Responsible for updating the advice guidelines annually in partnership with Manager of Clinical Content and Quality.
- Responsible for reviewing and updating quality audit tool guidelines and maintenance at least annually.
- Evaluates learning needs of the staff and collaborates with management team to coordinate learning/training opportunities. Coordinates and facilitates the orientation process of all new hires in the nurse advice center. Provide on-going training.
- Provide written feedback to managers and supervisors concerning quality concerns pertaining to individual performance as well as any system or work flow improvements.
- Maintain monthly statistics to track and communicate the number and type of concerns on a monthly basis to the Call Center management team. Be able to clearly and concisely present findings directly to managers and senior management.
- Serves as the department liaison to the call center advice team. Collaborate with Clinical Services to implement 'mini-mock' surveys to maintain regulatory DHR requirements.
Qualifications:
Basic Qualifications:
- Bachelor of Science in Nursing or an equivalent combination of education and experience.
- Current GA Register Nurse license.
- Five years of nursing experience.
- Demonstrated strong clinical knowledge base, judgment, and experience.
- Ability to analyze, integrate, and use quantitative data information in making business decisions and problem solving.
- 1-year quality improvement or statistical analysis experience required to include working knowledge of PI tools and methodologies.
- Excellent research and problem solving skills.
- Ability to perform multiple duties in a heavy workload environment with constant change.
- Working knowledge of Excel, Power Point and Visio.
Preferred Qualifications:
- Bachelor's Degree preferred.
- Knowledge of Cadence and Health Connect preferred.
- National certification in a nursing specialty, administration, education, or other related field (i.e. more specifically Telephone Nursing).
- Preferably one year in an ambulatory setting.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.