Quality Improvement Specialist Jobs in New York

TITLE: Clinical Quality Improvement Coordinator

REPORTS TO: Director of Nursing

POSITION SUMMARY: The Continuous Quality Improvement (CQI) Monitor is responsible for supporting the Director of Nursing in maintaining the agency's quality assurance, regulatory compliance, clinical documentation standards, and operational performance. This position serves as a critical link between the Nursing, Clinical Support, Intake, Scheduling, and Quality departments to ensure accurate documentation, timely follow-up, and continuous improvement throughout the agency.

The CQI Monitor performs detailed clinical record reviews, audits documentation for regulatory compliance, tracks key quality indicators, coordinates escalations in physician certifications, supports enhanced service referrals, and identifies opportunities for process improvement.

This position may be filled by either:

• A Licensed Practical Nurse (LPN); or
• A highly experienced senior healthcare administrative/clerical professional with demonstrated knowledge of home care operations, clinical documentation, quality improvement, and medical record management.

The CQI Monitor works independently while receiving supervision from the Director of Nursing.

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RESPONSIBILITIES:

Clinical Documentation & Quality Monitoring

• Conduct routine and targeted audits of clinical records to ensure compliance with New York State Department of Health (NYSDOH), CMS, Managed Care Organization, and Agency requirements.
• Audit:
• Initial Assessments
• Reassessments
• Supervisory Visits
• Medication Profiles
• Individualized Plans of Care
• Caregiver Instructions
• Progress Notes
• Clinical Documentation
• Discharge Records
• Review documentation for completeness, accuracy, timeliness, consistency, and regulatory compliance.
• Identify documentation deficiencies and coordinate corrective action with clinical staff.
• Monitor compliance with agency documentation standards and report trends to the Director of Nursing.
• Collect and trend common documentation errors for educational purposes and Quality Improvement initiatives.

Physician Orders & Plan of Care Management

· Audit physician orders (MD Orders) for completeness and regulatory compliance.

· Review Plans of Care (485s) for accuracy, completeness, and required signatures.

· Follow up on escalations from the Clinical Assistant regarding outstanding physician signatures.

· Escalate unresolved issues to the Director of Nursing as appropriate.

Enhanced Services Coordination

· Initiate referrals to enhanced clinical services as indicated by nursing assessments or agency protocols, including programs such as:

· CAPABLE

· NHTD/TBI

· GUIDE

· Care Management

· Social Care Network

· Other approved enhanced service programs

· Track referral status from initiation through completion.

· Follow up with referral partners to ensure timely processing and communication.

· Document all referral activity within the appropriate tracking systems.

Maintain and update agency quality monitoring tools including:

• Avoidable Hospitalization Tracking Spreadsheet
• Fall Tracking Reports
• Hospitalization Follow-Up Logs
• Nursing Productivity Reports
• Clinical Documentation Compliance Reports
• Quality Improvement Dashboards
• Key Performance Indicator (KPI) Dashboard

Monitor trends related to:

• Hospitalizations
• Emergency Department utilization
• Falls
• Missed visits
• Documentation compliance
• Timeliness of nursing visits
• Physician order completion
• Regulatory compliance metrics

Prepare reports for review by the Director of Nursing and Quality Committee.

Meetings & Communication

• Attend weekly meetings with the Director of Nursing for review of:
• Clinical statistics
• KPI Dashboard
• Documentation compliance
• Physician order status
• Hospitalization trends
• Audit findings
• Corrective action progress
• Quality Improvement initiatives
• Participate in Nursing, Quality Assurance, and interdisciplinary meetings as assigned.

Compliance Responsibilities

• Maintain strict adherence to HIPAA, patient confidentiality, and agency privacy policies.
• Maintain confidentiality of all Protected Health Information (PHI).
• Follow all NYSDOH, CMS, OSHA, and Agency policies and procedures.
• Report compliance concerns immediately to leadership.
• Demonstrate professionalism, integrity, and ethical conduct at all times.

Skills

· Strong attention to detail

· Excellent organizational skills

· Strong analytical abilities

· Medical record auditing

· Effective written and verbal communication

· Excellent follow-up skills

· Time management

· Critical thinking

· Ability to prioritize multiple projects

· Intermediate to advanced Microsoft Excel

Qualifications

· Current unrestricted New York State LPN License or

· Progressive healthcare administrative, records, or home care experience.

· Experience with Electronic Medical Records (EMR) systems.

· Experience with HHAeXchange or similar home care software.

· Excellent attendance, reliability, and professionalism.

Pay: $62,000.00 - $65,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Parental leave
• Retirement plan
• Vision insurance

Education:

• Associate (Preferred)

Experience:

• Health information management: 3 years (Required)
• EMR systems: 3 years (Required)
• Data entry: 3 years (Required)
• Internal audits: 3 years (Required)

License/Certification:

• Licensed Practical Nurse (Preferred)

Willingness to travel:

• 100% (Preferred)

Work Location: In person