Management Analyst (Data Abstractor)

PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center.

Position Summary:

Provide data abstraction for Quality Assurance Performance Improvement for the Tohono O'odham Nation Hospital Health Care (TONHC) Quality Management Program and assists with Performance Improvement projects throughout the facilities.

Scope of Work: This position is located in the Tohono O'odham Nation Health Care Sells Hospital. The goal of the data abstraction is to provide accurate ongoing, concurrent, and retroactive collection of data to identify opportunities, processes, and systems that improve patient outcomes. Works under the general supervision of the Director of Quality Management.

Essential Duties and Responsibilities: (Depending on the area of assignment, an incumbent may not be required to perform some of the duties listed below):

• Data Collection, Analysis, and Reporting: Conduct quality monitoring and performance improvement data collection and analysis for clinical and support services. By working with applicable software and conducting chart reviews to abstract patient data from the medical record and other patient data sources using criteria developed by regulatory and other agencies, including the Joint Commission and Center of Medicare and Medicaid (CMS).
• Data abstraction provides accurate ongoing, concurrent, and retroactive data collection to identify opportunities, processes, and systems that improve patient outcomes.
• Coordinate data collection core measures benchmarking projects.
• Provide Data management and abstraction support to the Safety/Emergency Management, Infection Prevention, Employee Health, Utilization Review, Discharge Planning, Case Management, Risk Management, Compliance, and other departments.
• Performance Improvement: Abstracts data from the medical record and other sources using predetermined clinical management and support services criteria by the Hospital Executive Committee, Clinical and Medical Staff. Performs objective assessment of patients' records based on specific criteria to determine the severity of deficiencies and refers to the appropriate subject matter experts. According to established criteria and assesses the validity, reliability, and accuracy of the collected data, Interprets complex data assists in providing education to clinical staff related to applicable standards and regulations.
• Coordinates core measure reviews, abstracts CMS required criteria, review accuracy, and loads files to Quality Net access screenshots with confirmation emails.
• Facilitates groups and committees to promote intra/interdepartmental performance activities to improve and resolve issues.
• Assists in the maintenance and organization of quality management and other records and committee minutes.
• Submit bi-annual Governing Body report for hospital activities and assignments.
• Service as the TONHC contact person for all employees for quality improvement data abstraction.
• Assists employees, supervisors, and others to file reports and specific forms for reporting quality data.
• Coordinate aspects related to the TONHC's risk management program.
• May be required to act on behalf of the Director of Quality Management as delegated.
• Assist with management and coordination of all aspects of the TONHC's Quality Management program and assist in developing policies, goals, and objectives as needed.
• Contribute to a team effort.
• Performs other job-related duties as assigned.

Knowledge, Skills, and Abilities:

• Knowledge of Tohono O'odham traditions, language, history, geography, and culture.
• Knowledge of applicable federal, state, tribal laws, regulations, and requirements.
• Knowledge of health-related issues, medical terminology, and health and child care education.
• Knowledge of comprehensive health programs and the full range of quality management knowledge, skills, and training.
• Knowledge and ability to teach and communicate effectively with the various TONHC departments to set standards and implement change.
• Knowledge of risk management and safety principles related to health care institutions and regulations enforced by TJC, CMS, OSHA, HCFA, APIC, and other specific hospital departmental rules and regulations that protect patients and staff working within those departments.
• Knowledge of disease-specific processes, therapeutic interventions to determine the severity of deficiencies.
• Knowledge and skill with electronic health record and Resource Patient Management System database.
• Knowledge of current research methods, including statistical compilation and interpretation, to participate in epidemiological surveys, field investigations, and research.
• Skills related to computers and data abstraction.
• Advanced skills with Microsoft Office and data abstraction software.
• Ability to comprehend and apply principles of statistical theory.
• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Ability to interpret and deal with several abstract and concrete variables.
• Ability to work with groups to teach and assist in initiation PI projects.
• Ability to effectively present information and respond to inquiries or complaints.
• Ability to maintain privileged, confidential information.
• Ability to work extended hours and various work schedules.
• Ability to work independently and meet strict timelines.
• Ability to operate company vehicles.

Minimum Qualifications:

• Degree from a professional nursing program approved by the legally designated State-accrediting agency when the applicant completed the program.
• Three (3) years of experience in health care is required.
• One year in data abstraction or conducting quality monitoring and performance improvement data collection and analysis for clinical and support services, performing objective assessments of patient records based on specific criteria, providing data management and abstraction support to various departments, compiling and presenting statistical data.

Licenses, Certifications, Special Requirements:

• Must have an active, current, and unrestricted license as a professional nurse in a State of the United States.
• Must have current certifications in Cardio Pulmonary Resuscitation (CPR).
• Upon recommendation for hire, a criminal background and a National FBI fingerprint check are required to determine suitability for employment, including a 39-month driving record.
• May require possessing and maintaining a valid driver's license (no DUIs or major traffic citations within the last three years).
• If required, must meet the Tohono O'odham Nation tribal employer's insurance requirements to receive a driver's permit to operate program vehicles.
• Based on the department's needs, incumbents may be required to demonstrate fluency in both the Tohono O'odham language and English as employment conditions.

Benefits

Medical, Dental, Vision, Group Life Insurance, Supplemental Life for Dependents, Short Term Disability, Long Term Disability, 401(k), Roth, Annual/Sick Leave eligible to accrue upon the first day of employment