Our mission-driven organization is focused on the “Triple Aim” - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.
The Culinary Health Fund serves over 100,000+ workers and 220,000 covered lives in the hospitality and gaming industry. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!
Integrity – Must be trustworthy and principled when faced with complex situations
Ability to build positive work relationships – Mutual trust and respect will be essential to the collaborative relationships required
Communication – Ability to generate concise, compelling, objective and data-driven reports
Teamwork – Working well with others is required in the Fund’s collaborative environment
Diversity – Must be capable of working in a culturally diverse environment
Continuous Learning – Must be open to learning and skill development. As the Fund’s needs evolve, must be proactive about developing new areas of expertise
Lives our values – Must be a role model for the Fund’s BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)
A purpose of this position is to manage the day to day operations of the Culinary Health Fund Quality Program. This will include data collection, analysis and presentation to drive quality activities and broader population health initiatives. This position will assist as directed in quality meetings and teams and help prepare agenda items for required meetings. The QI RN uses a comprehensive understanding of the care continuum across all healthcare settings to facilitate programs to measurably enhance the quality, process and cost effectiveness of delivered member care. The QI RN will be required to interface with a diverse range of clinical and administrative professionals, to resolve complex issues and to perform data analytic and reporting activities.
To be successful, the candidate must be comfortable with publically available and utilized data measures/standards (HEDIS, NQF, MIPS, etc), data collection, data input, data analysis and report development. Will require experience with clinical chart review and analysis to support peer review, physician profiling. The QI RN will need to be comfortable meeting with network providers to review quality metrics, and facilitate collaborative approaches for implementation of evidence based guidelines and other clinical tools to reduce variation in clinical practice and to optimize clinical outcomes.
ESSENTIAL JOB FUNCTIONS AND DUTIES
Years of Experience and Knowledge
Education, Licenses, and Certifications
OTHER JOB FUNCTIONS AND DUTIES
The information contained in this job description is designed to indicate the general nature and level of work performed in this job with a certain degree of specificity, where warranted. In no instance, however, should the duties, functions, qualifications, or requirements be interpreted as all-inclusive. Management may, at its discretion, assign or reassign functions and duties to or from this job at any time, due to reasonable accommodation or other reasons. Listed requirements, skills, qualifications and abilities included have been determined to illustrate the minimal standards required to successfully perform the position.