RN, Quality Assurance

Rochester, NY


The Project Nurse primary responsibilities include: Serves as the primary internal contact for national and state cardiac/vascular registry data management questions, issues or concerns, but not limited to clinical data collection, validation, delivery, reconciliation, and data management activity timeliness. Concurrently and retrospectively reviews medical records and data to identify patient care, process, and system issues (hospital and external) related to the care of the cardiac/vascular patients. Analyzes reports and clinical data to identify trends impacting quality outcomes. Works closely with the Hospital Quality Office, the Department of Medicine/Surgery Quality Teams and providers/staff from the Division to identify opportunities for clinical safety and quality improvement, and works with the team developing initiatives to improve quality outcomes. The position provides flexible hours, does not require nights/weekends/holidays, and allows for partially remote work from home.


Project Nurse/Quality Analyst

  • Utilizes national/state registries and other data sources to analyze patient outcomes, identify patterns and trends in care delivery in order to create safety/quality initiatives for Cardiac/Vascular patients.

  • Participates in root cause analyses and creates required documents as needed.

  • Completes audits on patient records and clinical documentation for quality purposes.

  • Assists with work related to the Quality Collaboratives the Department is involved in.

  • Serves as a liaison to outpatient clinics.

Quality Improvement

  • Develops project work-plans using Quality Improvement principles.

  • Utilizes evidence-based practice in facilitating ongoing quality improvement efforts to drive better patient outcomes.

  • Participates in initiatives for LOS reduction

  • Leads multidisciplinary teams on quality improvement initiatives.

  • Leads and facilitates Division Morbidity and Mortality Conferences in collaboratin with the Physicial QAL

  • Regularly reports quality improvement activities and quality outcomes to providers and clinical staff and is responsible for presentation of this work at various Department and Hospital level committees.

  • Maintains knowledge of current trends, issues and research in Quality Improvement.

Registry Data Coordinating

  • Accurately identifies patients for inclusion in the national and state databases through the application of strict inclusion/exclusion criteria and protocols.

  • Performs meticulous chart review and enters clinical data into the quality databases to identify opportunities for improved outcomes, reduced cost, improved LOS and best practice utilization of resources.

  • Complete and accurate collection of preoperative, operative and postoperative data through the effective utilization of the EMR and other Hospital databases.

  • Demonstrates appropriate utilization of resources necessary for accurate and timely data entry into the program’s database.

  • Demonstrates applicability of the methodology and the reliability of definitions utilized by reviewers within the program through inter-rater reliability, (IIR) testing


  • Establishes effective working relationships with members of the department, Nursing, and all other Hospital Departments.

  • Serves as an educational resource on the national/state registries and Cardiac Quality Program.

  • Identifies areas for streamlining and process improvement in the data collection process.

  • Prepares reports utilizing the national and state databases as requested.

  • Attends Department and Division level Quality Meetings/Conferences.

  • Participates in scheduled teleconferences with other national/state chart reviewers; attends the national registry conference annually.

Other Duties as assigned

  • Participates in other Quality/PI work as assigned

  • Collection of patient reported outcome measures, which may contain patient contact via telephone, email, or face to face interaction.


  • Current valid NYS Registered Nurse license required.

  • Bachelor’s degree preferred.

  • Minimum of 4 years clinical nursing experience, including 1 year of experience with clinical chart review, monitoring of clinical data/performance and performance/process improvement required.

  • Clinical experience in perioperative nursing, inpatient surgical unit, or surgical clinic preferred.

  • Quality improvement or patient safety knowledge and experience preferred.

  • Ability to interact with all members of the cardiac/vascular team and administrative staff in a professional and courteous manner required.

  • Detail oriented with strong organizational and prioritization skills and ability to work independently under general guidance required.

  • Proficiency in Microsoft Office (Word, Excel, PowerPoint, Access), software/web applications, and electronic medical record required.

  • Statistical knowledge preferred.

  • Clinical chart review and abstraction experience preferred.

  • Quality Assurance and Process Improvement (QA/PI) experience preferred.

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.

How To Apply

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled

Pay Range

Pay Range: $68,640 - $89,232 Annually

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

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Location: Strong Memorial Hospital
Full/Part Time: Full-Time