Registered Nurse Joint Venture Quality Program Coordinator

Primary Responsibilities

Quality Data Abstraction & Clinical Interpretation

• Collect abstract and validate clinical and operational quality data across all joint ventures applying nursing knowledge to ensure clinical accuracy and completeness for internal and external reporting.
• Interpret clinical documentation diagnoses medications and care plans within the EHR to accurately capture quality measure data that non-clinical abstractors may misread or miss.
• Maintain and update quality scorecards performance dashboards and tracking tools on a regular basis to reflect current performance across the JV portfolio.
• Generate recurring and ad hoc quality performance reports for the Quality Program Supervisor joint venture leadership and physician partners.
• Support accurate documentation and submission of quality and cost performance data in compliance with CMS MSSP ACO and other value-based care program requirements.

Performance Monitoring Gap Analysis & Clinical Assessment

• Monitor quality metrics and performance benchmarks across all joint ventures flagging variances trends and care gaps for supervisor review and action.
• Apply clinical nursing judgment to analyze root causes of quality score variances distinguishing between documentation gaps true care deficiencies and coding issues enabling more targeted and effective performance improvement interventions.
• Conduct clinical record reviews to identify missed or incomplete quality measure documentation providing specific actionable guidance to physicians and clinical staff for correction and improvement.
• Track care gap closure activities across joint ventures coordinating with clinical staff and physician offices to ensure timely completion and documentation.
• Support the preparation of performance summaries and trend analyses to inform physician engagement and leadership decision-making.

Clinical Education & Provider Engagement

• Educate physicians and clinical staff on quality measure requirements documentation best practices and evidence-based care standards using clinical expertise to communicate in terms that resonate with care teams.
• Serve as a trusted clinical resource for physician partners and nursing staff bridging the gap between quality program requirements and day-to-day patient care delivery.
• Lead or support clinical staff education sessions on risk adjustment documentation chronic disease management coding and preventive care measure completion.
• Review and interpret clinical guidelines and evidence-based protocols to inform quality improvement recommendations translating complex clinical standards into practical workflows for joint venture partners.

Care Coordination & Transitions of Care

• Coordinate care gap closure workflows between hospital and physician group partners applying clinical knowledge to triage urgency identify high-risk patients and prioritize outreach for maximum impact on quality outcomes.
• Conduct or support clinical outreach to patients with complex or chronic conditions providing nursing-level guidance on preventive care medication adherence and follow-up appointments to close quality measure gaps.
• Support transitions of care initiatives by reviewing discharge summaries identifying patients at risk for readmission and coordinating follow-up with outpatient care teams to reduce avoidable readmissions and complications.
• Maintain organized records of care coordination activities clinical outreach follow-up actions and outcomes across joint venture entities.

Meeting Coordination & Administrative Support

• Coordinate and prepare materials for quality meetings performance reviews and joint venture leadership presentations including agendas data summaries and follow-up action items.
• Maintain organized documentation of meeting minutes governance decisions performance records and compliance activities across the JV portfolio.
• Support the onboarding of new joint venture programs by assisting with data setup reporting infrastructure and workflow integration.

Compliance & Audit Support

• Assist in maintaining audit-ready documentation for regulatory and payer reviews ensuring quality and performance records are complete and accessible.
• Apply clinical knowledge to review and validate the accuracy of quality measure documentation during audit preparation identifying and correcting clinical discrepancies prior to submission.
• Support the development of Plans of Correction (POC) by compiling data tracking corrective action progress and documenting outcomes.
• Ensure data abstraction and reporting activities align with HIPAA privacy standards CMS program requirements and joint venture governance policies.

Qualifications

Education:
Associates or Bachelors degree in Nursing required. Bachelor of Science in Nursing (BSN) preferred.

Licensure:
Current unrestricted Registered Nurse (RN) license in the state of Indiana required.

Experience:
2 years of clinical nursing experience required with preference for experience in ambulatory care care management or quality improvement settings. Experience in an ACO value-based care or joint venture environment is a plus. Familiarity with CMS quality programs HEDIS/Stars measures or HCC risk adjustment preferred.

Technical Skills:

• Proficiency in Electronic Health Records (EHR) systems with ability to navigate and interpret clinical documentation.
• Experience with data visualization or reporting platforms such as PowerBI Tableau or Excel.
• Strong attention to detail with demonstrated ability to manage and validate clinical data sets accurately.

Knowledge Areas:

• Working knowledge of CMS regulations value-based payment models and quality reporting requirements.
• Familiarity with Stars quality measures care gap closure processes and chronic disease management standards.
• Understanding of HIPAA privacy standards healthcare data governance practices and clinical documentation requirements.
• Strong clinical assessment skills with ability to evaluate patient records identify care gaps and communicate findings effectively to physicians and multidisciplinary care teams.

Scope & Impact

• Supports quality performance across all joint ventures within the Deaconess Health System portfolio bringing clinical depth to data analysis and care improvement efforts.
• Contributes directly to CMS Star Ratings shared savings performance and regulatory compliance through clinically accurate data abstraction meaningful provider engagement and targeted care gap closure.
• Reports to the Quality Program Supervisor of Joint Ventures; collaborates with physicians clinical staff and operational leaders across joint venture entities.
• Plays a key role in building scalable clinically informed quality infrastructure to support the continued growth and performance of the JV portfolio.

Required Experience:

IC