Michele O.

Quality Improvement Rn @Community Health Choice

Houston, TX, US

Collect, analyze, and interpret clinical and performance data to identify trends, reduce care variation, and improve health outcomes.• Lead investigations of Abuse, Neglect, and Exploitation (ANE) cases, ensuring timely reporting, corrective action, and compliance with regulatory protocols.• Design and refine QI programs and performance improvement strategies that enhance provider engagement, member satisfaction, and overall clinical effectiveness.• Collaborate cross-functionally with clinical, compliance, and operations teams to implement evidence-based process improvements supporting regulatory deliverables.• Track and trend key quality indicators and ensure all HHSC, CMS, and TDI reporting deliverables are met within required timelines.• Develop and maintain compliance and accreditation documentation, including reports for QAPI, CMS QIS, and URAC quality initiatives.• Facilitate Quality Improvement Committee (QIC) meetings and interdepartmental workgroups, presenting findings and recommendations to executive leadership.• Evaluate program performance and project outcomes, identifying gaps and recommending sustainable corrective actions.• Maintain confidentiality and uphold ethical standards in all quality improvement and clinical data management practices.• Contribute to the annual Quality Improvement Program Evaluation and departmental business plan, aligning activities with corporate strategy and compliance objectives.