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RN Quality Measure Specialist
Banner Health. Perform clinical validation to ensure measure accuracy and compliance with CMS requirements .
Tech Stack
Tools & technologiesOracle
About the role
Key responsibilities & impact- Perform clinical validation to ensure measure accuracy and compliance with CMS requirements
- Conduct medical record abstraction for assigned measures
- Identify and resolve data and logic discrepancies with internal teams and external vendors
- Support timely and accurate regulatory submissions
- Perform clinical data abstraction and validation for IQR, OQR, IPFQR, Core Measures, TJC, and MIPS (CQM and eCQM)
- Apply clinical knowledge and established measure specifications to ensure accurate, complete, and compliant data capture
- Follow defined processes for discrepancy escalation and resolution
- Adhere to standardized workflows, tools, and documentation requirements
- Contribute to clinical quality data review and validation, including report logic review
- Participate in cross-training, knowledge sharing, and quality-related initiatives
- Work primarily in either validation or abstraction, with cross-training in both areas
Requirements
What you’ll need- Bachelor’s degree in Healthcare or a related field or equivalent level of education and experience
- Current valid Registered Nurse (RN) license
- Minimum of three to five years of clinical experience in an acute care setting
- Strong clinical background and knowledge
- Critical thinking, analytical reasoning, and problem-solving skills for complex medical cases
- Experience with electronic medical records and clinical documentation
- Strong communication and organizational skills
- Ability to work autonomously in a complex and quickly changing remote environment
- Ability to navigate a variety of separate computer programs
- Working knowledge of Cerner Millennium EHR (Oracle Health's EHR)
- Preferred: working knowledge of quality metric specifications and clinical coding conventions
- Preferred: experience with clinical quality abstraction and/or validation processes
- Preferred: experience in high-acuity or critical care environments, such as ED, ICU, or PACU
- Preferred: experience supporting regulatory programs
- Preferred: exposure to report logic, external vendors, or regulatory audits, including IRR/ARR activities
- Preferred: experience with Oracle Health EHR (Cerner Millennium)
- Preferred: experience contributing to process improvement initiatives
- Preferred: proficiency with Microsoft Office (Excel)
- Scheduled availability between 8:30AM and 4:30PM Arizona Time
Benefits
Comp & perks- Flexible scheduling may be available after orientation
- Cross-training provided to support workload balancing and team flexibility
- Banner Health total rewards package (not itemized in the posting)