Quality Management Rn Jobs

Required Education: Healthcare related undergraduate degree required

Preferred Education: Graduate degree in Business, Healthcare Administration, or a related field

We're bringing to life a healing ministry through compassionate care.

What Makes You a Good Match for Mercy?

If you are relying on your education to meet qualification requirements:

Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).

Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required.

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

Strong CM background, Project management and process improvement experience.

Conducts special clinical studies related to patient care management.

Detailed knowledge of Title 22, TJC and NCQA requirements for licensure and accreditation.

Must be able to work in a Labor/Management Partnership environment.

Monitors compliance with quality improvement requirements.

Minimum two (2) years of experience as a licensed hospital nurse required.

Basic Education and/or Experience Requirements

Participate in own professional development by maintaining required competencies, identifying learning needs and seeking appropriate assistance or educational offerings.

Utilize computer programs to effectively collect, analyze, present, and communicate data to the staff, managers, and leaders.

Knowledge of pharmacovigilance processes and procedures per the FDA laws and regulations

Five (5) years of relevant clinical nursing experience in an acute care setting and /or home or ambulatory home infusion.

Able to manage multiple priorities and tasks efficiently and effectively

Collaborate with management and subject matter experts to understand desired performance, assess learning needs, and develop appropriate training solutions.

Must possess working knowledge of general hospital operations, JCAHO, OSHA, Medicare COP, and state requirements.

Required: 1-3 years of acute care hospital experience, or equivalent experience. Preferred: 5 or more years.

Location LAREDO, TX (Laredo Medical Center)Full Time

Location LAREDO, TX (Laredo Medical Center)

Participate in the assessment, planning, implementation, and evaluation of clinical transformation activities for an assigned service or population.

Department: Ascension Care Management Insurance

3+ years of Performance Improvement / Quality Management in a Managed Care organization

Knowledge of quality improvement principles, practices and procedures.

Has experience in coordinating inter departmental committees.

Experience working on RFPs and winning bids

Extensive knowledge with completing state reports, examples: APM worksheet, THSteps, CAPs, QAPI

Training/experience in performance-improvement/risk-management; certification preferred

Recognizes patients’ rights and responsibilities and supports them in performance of job duties

Adheres to safety policies and procedures in performing job duties and responsibilities

Participates in continuing education and other learning experiences

Shares knowledge gained in continuing education with staff

Seeks new learning experiences by accepting challenging opportunities and responsibilities

Responsible for the management and development of new and existing staff in a remote work setting.

Acts as liaison to Quality Management staff and represents in committees and workgroups whose focus is quality improvement projects.

Conducts analysis and provides summary reports and analysis to senior management.

Executes on organizational efforts in ongoing quality improvement processes to ensure compliance with State, Federal, regulatory and accrediting body’s standard requirements.

Bachelor’s Degree or equivalent work experience required.

Three to five (3 to 5) years of supervisory or leadership responsibilities in Quality Improvement.

Working knowledge of laws, regulations, accrediting, licensing, monitoring agency standards and requirements applicable to medical staff, risk management and safety.

Certified Professional in Healthcare Risk Management (CHPRM) certification required OR achievement of CHPRM certification within 2 years of becoming eligible.

Four or more years of progressive health care management experience in medical staff issues, clinical practice areas and/or quality/risk management.

REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE

Member of the appropriate clinical and non-clinical committees within the organization and Trinity Health to provide risk management/patient safety input.

Tracks and trends key data elements related to patient and visitor safety and risk management.

Strong communication, collaboration, influencing, teamwork, project and time management skills required.

Basic Windows skills to include keyboarding, mouse movement and computer data entry skills to enter patient information.

Serves as clinical expert for patient safety and provides education regarding patient safety initiatives.

Partners with clinic administrator/managers to implement evidence-based best practices surrounding infection control, patient safety, and clinical standards.

All other duties as assigned including department-specific functions and responsibilities:

Minimum three (3) years of clinical experience in a hospital or clinic setting.

Knowledge of managed care, utilization management, and quality management

Maintains current knowledge of State, Federal and other applicable regulatory/accrediting agency requirements as they apply to department functions

Demonstrate and maintain current working knowledge of the required systems, procedures, forms and manuals

2 years of experience as practicing RN in hospital/healthcare setting

2+ years of experience in health insurance field

2+ years of experience processing potential quality inquiries

Seeks opportunities to enhance ongoing education needs within Care Management.

Develops and implement department-specific staff educational activities for Care Management.

Certification in Case Management preferred (ACM, CCM, CMAC)

Five years’ case management experience required

Applies effective teaching-learning methodologies to care management staff development for all new and existing care managers and social workers

Monitors care management staff workflow and documentation in support of the following’

Strong understanding of project management requirements, quality assurance and change management processes preferred

Minimum of two (2) years’ experience in a clinical setting (RN, PCA, LVN, MA, CLS, Phlebotomist, etc.)

Basic understanding of healthcare practices/processing/clinical data to assist in developing report requirements and data analysis

Familiarity with regulatory requirements preferred

Certification in Business Objects (Crystal), MS Reporting Services (MSRS), and/or SQL Server Reporting Services

Bachelor’s Degree in Nursing, Computer Science, Health Care Administration or related field

5 years of recent clinical practice with demonstration of progressive teaching experience required

3 years of professional development, consultation, or leadership experience preferred.

Excellent communication, oral presentation and professional writing skills required.

Provides content expertise and facilitates clinical policies and procedures development, education and implementation into practice.

Evaluates effectiveness of education, professional development, or process change interventions.

Coordinates and facilitates complex education and professional development programs.

Minimum of two (2) years of full-time experience as a RN post-orientation or post-residency training.

National Certification in Clinical Specialty preferred

Certified in American Heart Association’s Basic Cardiac Life Support (BLS).

Other preferred RN attributes are unit specific. Please refer to the specific clinical unit.

2-3 years experience in a supervisory or management role

Certification in Quality Management a plus (CPHQ, HCQM)

Responsible for management of the QM staff, which includes a Health Educator, QA Coordinator, and Credentialing Coordinator

3-5 years experience in a managed health care environment; Health Plan, IPA, MSO preferred

Develops Policies and Procedures, workflows and required documents to meet federal and state regulatory requirements, as needed in focus area

Ensures gap reports and educational materials are available to Providers

Training: Working knowledge of Quality/Performance Improvement, State Licensing and Certification process, and HFAP Standards, risk management and relevant legal aspects.

Oversight, direction and management of the Quality/PI & RM Program (hospital wide/Medical Staff) consistent with PI/RM Plan.

Manages all facets of the Risk Management process

Oversight and management of the AHRQ Patient Safety Survey

Provide education/guidance to staff in areas of responsibilities.

Support of management of physician Case Review files

Knowledge and good understanding of regulatory requirements, guidance's and processes in the field of IVDs/MDs

Ensures products and services are developed, manufactured, tested, and delivered according to established procedures meeting Quality requirements.

Develop and implement Quality training plans that provide necessary organizational knowledge to achieve company objectives.

A minimum of 12 years of relevant industry experience required.

Expert knowledge in the interpretation and application of relevant Domestic and International Regulations and Industry Standards(e.g. ISO, QSR, MDSAP, etc.).

Establish, maintain and improve reports of Quality data to assist continuous improvement and assess the effectiveness of the facilities Quality system.

Five (5) to Seven (7) years of clinical experience in Quality Management

Minimum three (3) years leadership experience in Quality Management required, acute care experience preferred.

Specialized professional certification in a related field

Challenging and rewarding work environment

Competitive Compensation & Generous Paid Time Off

Excellent Medical, Dental, Vision and Prescription Drug Plans