Company :

Job Description : 

GENERAL OVERVIEW:

The Performance Improvement (PI) Specialist is responsible to planning, coordinating and managing all performance improvement projects and activities which includes leading and facilitating teams, creating action plans and driving toward deadlines. Must be self-directed and demonstrate the ability to oversee several projects simultaneously.  The Performance Improvement Specialist position is responsible for reviewing clinical documentation and related processes to assess for appropriate treatment, documentation, adherence to protocols, and overall outcomes. This position provides pivotal support to the quality and safety divisions and other key internal and external stakeholders as needed to improve patient outcomes and organizational performance.  

ESSENTIAL RESPONSIBILITIES:

• Responsible for planning, coordinating and managing assigned projects aimed at supporting the needs of the quality and safety divisions including quality, infection prevention, regulatory and patient safety. Facilitates recognition of performance improvement opportunities based on observation or data analysis, medical record/ process reviews and audits, measuring compliance to protocols. Coordinates the peer review process when appropriate and escalates recognized deviations from best practice to appropriate leaders. (50%)

• Collaborates with all relevant internal and external staff to ensure that assigned projects meet relevant accreditation standards and requirements and that work is coordinated to accomplish goals in the most cost-effective, valid and accurate way possible. Takes appropriate actions to ensure that defined time frames are met, documentation is accurate, and confidentiality is maintained. Facilitates work related to core measures, HAC, mortality, readmission and PSI reduction programs in coordination with nursing and medical staff leaders in an effort to promote positive patient outcomes and to meet internal/external quality goals related to P4V/VBP reimbursements. (50%)

• Other duties as assigned.

QUALIFICATIONS:

Minimum

• 1-3 years experience in acute-care nursing

• 0 – 1 year experience in quality development and/or large quality initiatives

• Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC).

Preferred

• Associate’s degree in Nursing

• Bachelor’s degree in Nursing

• Lean Six Sigma certification

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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