Children's National Medical Center
Clinical Quality Improvement (QI) Lead, HYBRID
Children's National Medical Center, Washington, District of Columbia, us, 20022
Job Description
Clinical Quality Improvement (QI) Lead, HYBRID - (25000349)
Description The Clinical Quality Improvement (QI) Lead in collaboration with HSCSN Quality Assurance leadership leads the development, planning, and implementation of QI initiatives to ensure the delivery of quality health care and services. The QI lead will also support quality oversight, assessment, and NCQA compliance initiatives. She/he will be a subject‑matter expert in quality improvement and quality assurance and will be responsible for working with internal and external stakeholders.
Qualifications Minimum Education
Bachelor's Degree – Ideal candidate should hold bachelor’s degree with public health background or other health related academic credentials and clinical background (RN, LPN, social worker etc.) (Required)
Master's Degree in MSN, MPA, or MPH. (Preferred)
Minimum Work Experience
2 years of experience in developing, implementing, and evaluating clinical QI/PI initiatives, NCQA Accreditation, and HEDIS in a MCO (Required)
2 years of professional clinical experience. (Preferred)
Required Skills/Knowledge
Ability to work under pressure independently, strong organizational and analytical (qualitative/quantitative analysis) skills is required.
Experienced in facilitating and coordinating various QI workgroups including HEDIS trend analysis, developing and implementing various initiatives.
Demonstrated project management skills with the ability to handle multiple concurrent projects.
Ability to work effectively with providers and multidisciplinary teams across departments.
Experience in NCQA accreditation readiness activities (managing accreditation project plan, supporting team in reviewing/writing NCQA compliant analysis, preparing materials for survey etc).
Experience with Medicaid regulatory compliance and external quality review organization (EQRO) activities such as managing Performance Improvement Projects (PIPs).
Excellent written and verbal communication skills. Must be able to understand and use CQI principles/tools (Institute for Health Care Improvement's Model for Improvement).
Knowledge of computer applications MS Suite (Word, Excel, PowerPoint, Adobe Pro, Outlook).
Required Licenses and Certifications
Registered Nurse Licensed as a Registered Nurse (RN). (Preferred)
CPHQ preferred.
Job Functions Essential job duties:
Participates and coordinates quality improvement performance measures including but not limited to:
Analysis (Quantitative and Qualitative)
Performs root cause analysis to assess low performance on chosen indicators, sets SMART aims with appropriate stakeholders and identifies key drivers for success.
Identification of opportunities for improvement on internal quality outcome measures (KPI, HEDIS, CAHPS etc.) and collaborate with various teams to design, implement, and proactively monitor outcomes.
Maintains expertise in continuous quality improvement principles and concepts.
Design methodology, collect and interpret data, conduct clinical and statistical analyses, and monitor outcomes.
Acts as a project leader by overseeing, coordinating, monitoring, and reporting on assigned projects and quality workgroup.
Prepares detailed project plans including work plans, resources requirement, timeframes, and methodology to achieve project objectives.
Reviews project status at each phase, identifies variances from approved timetables, and proposes modified time frames.
Collects, analyzes, and acts upon quality outcomes data, with respect to members and providers to effectively manage care including measurement of specific procedures, and the development, implementation, and evaluation of interventions.
Analyzes member/provider survey data and identify opportunities to improve results.
Participates and lead discussions, facilitate trainings related to QI tools and NCQA accreditation.
Support HEDIS inventions/initiatives.
Partners with Business Analysts, Business Informatics specialists, and other available resources (i.e. consultants) to develop needed reports to assess outcome and process measures needed for improvement work.
Develop targeted/general member and provider educational interventions to support and improve specific QI initiatives, working in collaboration with internal and external stakeholders.
Tracks and monitors quality of care/services issues regarding members and/or providers.
Participate and support the HSCSN Quality Management Committees and sub-committees.
Other job duties:
May perform other duties in addition to those outlined in this job description.
Organizational Accountabilities
Demonstrates understanding of quality of service and collaborates with co‑workers to ensure excellence standard is achieved.
Innovates through improvement of care and/or efficiency of operational processes.
Dedicated to a standard of performance excellence and high quality.
All In
Embraces changes/improvements and actively participates in the implementation of new/improved programs, technology, new equipment, systems and resources that promote quality of care, safety and efficiency.
Identifies, prioritizes and selects alternative solutions to determine best outcome.
Action Oriented
Maintains a high level of activity/productivity, meeting deadlines and appropriately prioritizing tasks to meet business demands.
Anticipates problems and attempts to solve before they develop.
Supervisory Responsibilities
None.
Category III: Job does not involve exposure to blood, body fluids, non‑intact skin or tissue specimens. Incumbent does not perform or help in emergency medical care or first aid as a part of his/her job.
Protected Health Information Access Level
Level IV - Full Access: Incumbents in this job may access any protected health information associated to a customer's needs, the service(s) rendered and the position's functions.
This job operates in a hospital or office environment.
Physical Requirements
Light Work: Lifting 25 lbs. maximum with frequent lifting and/or carrying of objects weighing up to 10 lbs.
Travel Requirements
DC Residents Encouraged to Apply.
Primary Location District of Columbia-Washington
Work Locations HSCSN - Vermont Ave 1101 Vermont Ave NW Washington 20005
Job Non-Clinical Professional
Organization HSC W/Special Needs
Position Status : R (Regular) - FT - Full-Time
Shift : Day
Work Schedule : Full Time 40 hr/wk
Job Posting Full-Time Salary Range 79289.6 - 132163.2
Health Services for Children with Special Needs (HSCSN) is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. The “Know Your Rights” poster is available here: and the pay transparency policy is available here: Know Your Rights Pay Transparency Nondiscrimination Poster
Health Services for Children with Special Needs (HSCSN) follows a “drug‑free” work environment policy: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children’s National and its affiliates maintain the right, in accordance with our policy, to enforce a drug‑free workplace, including prohibiting recreational or prescribed marijuana.
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Description The Clinical Quality Improvement (QI) Lead in collaboration with HSCSN Quality Assurance leadership leads the development, planning, and implementation of QI initiatives to ensure the delivery of quality health care and services. The QI lead will also support quality oversight, assessment, and NCQA compliance initiatives. She/he will be a subject‑matter expert in quality improvement and quality assurance and will be responsible for working with internal and external stakeholders.
Qualifications Minimum Education
Bachelor's Degree – Ideal candidate should hold bachelor’s degree with public health background or other health related academic credentials and clinical background (RN, LPN, social worker etc.) (Required)
Master's Degree in MSN, MPA, or MPH. (Preferred)
Minimum Work Experience
2 years of experience in developing, implementing, and evaluating clinical QI/PI initiatives, NCQA Accreditation, and HEDIS in a MCO (Required)
2 years of professional clinical experience. (Preferred)
Required Skills/Knowledge
Ability to work under pressure independently, strong organizational and analytical (qualitative/quantitative analysis) skills is required.
Experienced in facilitating and coordinating various QI workgroups including HEDIS trend analysis, developing and implementing various initiatives.
Demonstrated project management skills with the ability to handle multiple concurrent projects.
Ability to work effectively with providers and multidisciplinary teams across departments.
Experience in NCQA accreditation readiness activities (managing accreditation project plan, supporting team in reviewing/writing NCQA compliant analysis, preparing materials for survey etc).
Experience with Medicaid regulatory compliance and external quality review organization (EQRO) activities such as managing Performance Improvement Projects (PIPs).
Excellent written and verbal communication skills. Must be able to understand and use CQI principles/tools (Institute for Health Care Improvement's Model for Improvement).
Knowledge of computer applications MS Suite (Word, Excel, PowerPoint, Adobe Pro, Outlook).
Required Licenses and Certifications
Registered Nurse Licensed as a Registered Nurse (RN). (Preferred)
CPHQ preferred.
Job Functions Essential job duties:
Participates and coordinates quality improvement performance measures including but not limited to:
Analysis (Quantitative and Qualitative)
Performs root cause analysis to assess low performance on chosen indicators, sets SMART aims with appropriate stakeholders and identifies key drivers for success.
Identification of opportunities for improvement on internal quality outcome measures (KPI, HEDIS, CAHPS etc.) and collaborate with various teams to design, implement, and proactively monitor outcomes.
Maintains expertise in continuous quality improvement principles and concepts.
Design methodology, collect and interpret data, conduct clinical and statistical analyses, and monitor outcomes.
Acts as a project leader by overseeing, coordinating, monitoring, and reporting on assigned projects and quality workgroup.
Prepares detailed project plans including work plans, resources requirement, timeframes, and methodology to achieve project objectives.
Reviews project status at each phase, identifies variances from approved timetables, and proposes modified time frames.
Collects, analyzes, and acts upon quality outcomes data, with respect to members and providers to effectively manage care including measurement of specific procedures, and the development, implementation, and evaluation of interventions.
Analyzes member/provider survey data and identify opportunities to improve results.
Participates and lead discussions, facilitate trainings related to QI tools and NCQA accreditation.
Support HEDIS inventions/initiatives.
Partners with Business Analysts, Business Informatics specialists, and other available resources (i.e. consultants) to develop needed reports to assess outcome and process measures needed for improvement work.
Develop targeted/general member and provider educational interventions to support and improve specific QI initiatives, working in collaboration with internal and external stakeholders.
Tracks and monitors quality of care/services issues regarding members and/or providers.
Participate and support the HSCSN Quality Management Committees and sub-committees.
Other job duties:
May perform other duties in addition to those outlined in this job description.
Organizational Accountabilities
Demonstrates understanding of quality of service and collaborates with co‑workers to ensure excellence standard is achieved.
Innovates through improvement of care and/or efficiency of operational processes.
Dedicated to a standard of performance excellence and high quality.
All In
Embraces changes/improvements and actively participates in the implementation of new/improved programs, technology, new equipment, systems and resources that promote quality of care, safety and efficiency.
Identifies, prioritizes and selects alternative solutions to determine best outcome.
Action Oriented
Maintains a high level of activity/productivity, meeting deadlines and appropriately prioritizing tasks to meet business demands.
Anticipates problems and attempts to solve before they develop.
Supervisory Responsibilities
None.
Category III: Job does not involve exposure to blood, body fluids, non‑intact skin or tissue specimens. Incumbent does not perform or help in emergency medical care or first aid as a part of his/her job.
Protected Health Information Access Level
Level IV - Full Access: Incumbents in this job may access any protected health information associated to a customer's needs, the service(s) rendered and the position's functions.
This job operates in a hospital or office environment.
Physical Requirements
Light Work: Lifting 25 lbs. maximum with frequent lifting and/or carrying of objects weighing up to 10 lbs.
Travel Requirements
DC Residents Encouraged to Apply.
Primary Location District of Columbia-Washington
Work Locations HSCSN - Vermont Ave 1101 Vermont Ave NW Washington 20005
Job Non-Clinical Professional
Organization HSC W/Special Needs
Position Status : R (Regular) - FT - Full-Time
Shift : Day
Work Schedule : Full Time 40 hr/wk
Job Posting Full-Time Salary Range 79289.6 - 132163.2
Health Services for Children with Special Needs (HSCSN) is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. The “Know Your Rights” poster is available here: and the pay transparency policy is available here: Know Your Rights Pay Transparency Nondiscrimination Poster
Health Services for Children with Special Needs (HSCSN) follows a “drug‑free” work environment policy: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children’s National and its affiliates maintain the right, in accordance with our policy, to enforce a drug‑free workplace, including prohibiting recreational or prescribed marijuana.
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