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Quality Assurance, UR & Case Management

Passion + Vision + Integrity = Excellence

Ensure consistency and the highest ethical standards across our entire organization. Our quality assurance team drives ongoing improvement by fostering an environment of support, providing technical and specialized consultative services, and inspiring ongoing excellence.

Quality Management Coordinator RN

Location: Portland, OR Additional Locations:
Job Number: 865240 Date posted: 02/27/2020

To provide coordination and implementation of the NW Region Kaiser Permanente medical staff Quality programs, including the appropriate identification and triage of medical errors and Significant Events. To teach and promote Patient Safety principles (including Human Factors training) throughout the NW Region while interacting with team members from a variety of backgrounds. To conduct and teach Root Cause Analysis (RCA) for resolution of systems issues. To collect and triage Patient Safety issues from a variety of sources, assuring appropriate follow-up, resolution, reporting and documentation. To lead or consult with work groups or teams charged with systems redesign. To collect, collate, and trend data for theme or issue prioritization and documentation. To develop and conduct studies and collation of data for trend reports. To coordinate and facilitate Regional medical staff department meetings as well as Peer Review forums meetings. To provide documentation of medical staff issues and departmental meeting minutes in an appropriate format utilizing active voice and appropriate recommendations and actions. To facilitate CQI projects for medical staff as indicated. To facilitate Chief, practice or focus practitioner reviews as directed, based on assessment of departmental data. To participate in activities to meet regulatory agency and accreditation program requirements.

Essential Responsibilities:

  • Facilitates the NW Permanente medical staff Quality programs. Provides expertise, direction, and consultation regarding KPNW Patient Safety quality initiatives and quality improvement methods. Developing and maintaining quality plans and policies for departments as well as evaluation of departmental quality programs. Identifies quality/safety trends and patterns of care or systems that warrant further review. Analyzes quarterly practitioner data to identify trends and consults with the Department Chief regarding Performance Improvement Plans, Chief or focus reviews. Assists with annual Quality reports for assigned departments at the discretion of the Department Chief. Reviews and trends data to facilitate departmental education and work prioritization. Provides medical staff reports and information to the Credentialing Committee as indicated. Plans peer review sessions for 'facilitated' medical staff departments throughout the NW Region, ensuring records, selected data and evaluation materials are available for the QA Representative(s) review. Consults with the QA Rep during the session, providing knowledge of issue analysis and adjudication. Records results of peer reviews, documentation reviews, data analysis and/or systems review and submits for data entry, assigning clinical indicators and Patient Safety Indicators as appropriate. In collaboration with the QA Representative or Department Chief, plans and executes Quality department meetings for 'facilitated' departments and provides documentation of quarterly Quality minutes for hospital (KSMC, WMC & Ambulatory Surgery Centers) medical staff departments. Assures Credentialing and Privileging is notified of practitioners who may require a focus review or Performance Improvement Plan. Conducts and oversees investigations into adverse events, developing sufficient documentation to identify and evaluate human factors and system failures for the purpose of recommending changers to prevent recurrence and ensure patient safety. Acts as a leader in issues of performance measurement, quality improvement, and patient safety.

  • Identifies possible Significant Events utilizing approved criteria and assures Significant Events are verified and reported as required. Facilitates Root Cause Analysis of Sentinel & Significant Events throughout the NW Region by identifying appropriate team members, conducting the RCA or serving as a consultant, assuring documentation and distribution of recommendations and actions and appropriate follow-up.

  • Reports and tracks departmental recommendations/actions. Refers and communicates issues between committees/departments and individuals, to ensure appropriate follow-up occurs. Facilitates resolution of issues and documents that appropriate follow-up has occurred. Assures elevation of high-risk issues or trends to the appropriate entity for resolution.

  • Identifies, triages, and refers patient care, patient safety, and systems issues requiring further review, utilizing a variety of sources (QA Mailbox, Medical Legal, etc.). Reviews medical records, RRS, EpicCare, and other data sources using indicators and review criteria.

  • Gathers, analyzes, collates, and formats data for studies.

  • Maintains knowledge of The Joint Commission, Center Medicare Service Quality Improvement Organization (Livanta LLC) and other regulatory agencies, as well as federal and state regulations relating to Peer Review & Quality Resource Management. Maintains confidentiality in accordance with confidentiality policy statement and state/federal Peer Review laws.

  • Performs other duties as requested.

  • Basic Qualifications:


  • Minimum five (5) years of direct nursing care experience.

  • Minimum five (5) years of experience with Quality processes and tools (Root Cause Analysis, FMEA, Lean, Six Sigma, etc.).

  • Education

  • Bachelor degree in a health care field OR four (4) years of experience in a directly related field.

  • High School Diploma or General Education Development (GED) required.

  • License, Certification, Registration

  • Current Oregon or Washington RN license in state where assigned required upon hire/transfer.

  • Certified Professional in Health Care Quality (CPHQ) required within 24 months of hire/transfer.

  • Additional Requirements:

  • Demonstrated use of CQI principles and techniques including RCA, data abstraction and analysis, and work team facilitation.

  • Demonstrated ability to develop successful interpersonal and professional relationships with diverse populations (administrators, physicians, nurses, aides, technicians and other personnel).

  • Demonstrated critical thinking, knowledge of medical service delivery in an acute care and/or outpatient setting.

  • Demonstrated self-motivation and ability to work independently or as a contributing team member.

  • Demonstrated group facilitation & problem solving skills.

  • Demonstrated project management skills.

  • Flexibility in work assignments and work locations within the organization.

  • Positive and supportive attitude even when dealing with adverse outcomes.

  • Proficient in PC based computer skills, as well as Excel and PowerPoint.

  • Ability to work in a Labor Management Partnership.

  • Demonstrated knowledge of systems and data collection/analysis.

  • Excellent written/oral communication skills, demonstrated ability to facilitate teams and serve as a consultant to diverse groups.

  • PC computer skills & familiarity with CQI techniques and principles.

  • Preferred Qualifications:

  • Minimum three (3) years of experience with Utilization Management and/or Risk Management principles and practices.

  • Minimum three (3) years of experience in nursing leadership and/or management.

  • Minimum three (3) years of work experience in Peer Review activities & processes.

  • Intensive care and/or administrative experience.

  • Bachelor Science Nursing

  • Involvement with self-governed work teams, interpretation of performance data, or demonstrated use of CQI tools and techniques.

  • Demonstrated knowledge of statistics, systems theory and organizational behavior.

  • Certified Professional in Health Care Quality (CPHQ) preferred.

  • Proficient in use of Lotus Notes, EMR (KP Health Connect), RRS systems.

  • Demonstrated use of Quality processes and tools (Root Cause Analysis, FMEA, etc.), Utilization Management, and/or Risk Management principles and practices.
  • Primary Location: Oregon,Portland,Kaiser Permanente Building 500 NE Multnomah St. Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon-Fri Working Hours Start: 8:00 AM Working Hours End: 5:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Individual Contributor Job Category: QA / UR / Case Management Department: Quality Resource Management Travel: Yes, 10 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

    About QA, Ur & Case Management Careers

    Careers In QA, Ur & Case Management

    As an organization, we are committed to delivering the same exemplary care no matter who you are, where you are, or what your needs. But how are those standards defined, measured, and assessed? That's where our quality assurance team comes in. Implementing the action plans and initiatives that will drive successful practices, you'll work across the organization to foster the necessary education, communication, and innovation that will enable us to operate as one KP — with our mission and goals in complete alignment.

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