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Clinical Quality Manager (RN Required)

RCM Healthcare Services New York, NY Full-Time
$95,000.00 - $105,000.00 / year
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Clinical Quality Manager role in Midtown Manhattan Office. 

 

This Health Plan based in Midtown Manhattan has been providing care to the military community for over 30 years. Health care is offered to active duty family members, retirees and their family members.  They offer world-class health care for their patients, including wellness and disease prevention programs, disease management, and continuity of care. The Health Plan were among the first to implement the patient-centered medical home concept, and they have been pioneers in tele-medicine, 24-hour nurse help lines, and in-home patient monitoring.

 

Clinical Quality Manager, Midtown Manhattan Office

Six Figure Salary and Generous Benefit

 

Job Summary
The primary function of the Clinical Quality Manager is to design, implement and evaluate complex quality and process improvement projects. These functions are carried out in a cost effective and measurable design.
 Responsibilities

  • Design, implement and evaluate quality measures from publicly reported scorecards, (Medicare.gov, Compare and Leapfrog)
  • Assists in developing an annual clinical quality management program workflow, including clinical studies and quality improvement projects.
  • Compiles data to create annual clinical quality management program report.
  • Contributes to process improvement efforts and leading team projects as needed.
  • Monitors clinical and administrative complaints, grievances and executive inquiries.
  • Participate with internal departments and external vendors to create and implement corrective action plans to resolve issues. 

Years of Experience

  • Minimum 2 years in healthcare quality management experience and minimum 5 years clinical nursing experience. Quality assurance/improvement experience in a managed health plan, integrated health care system, or health care accreditation or regulatory agency.
  • Current and Unrestricted RN License -Required.
  • Bachelors (Nursing, Healthcare Management, Public Health) -Required.
  • MSN, MS, MBA, MPH –Preferred.
  • Certified Professional in Healthcare Quality (CPHQ)-Preferred.  

Technical Skills

  • Ability to read, abstract and analyze medical records as well as other healthcare quality data.
  • Understanding of standardized medical terminology.
  • Candidates should have strong analytical skills, attention to detail, strong oral, written, interpersonal and presentation skills.
  • Knowledge of health insurance industry, TRICARE, Medicare, Medicaid.
  • Ability to work independently and adjust priorities as required. 
  • Proficiency in Microsoft Office (2010) Word, Excel, PowerPoint, and Access.  Must be organized and detail oriented.  
     

Six Figure Salary with Excellent Benefits

Recommended skills

Attention To Detail
Medicare
Medicaid
Business Process Improvement
Quality Management
Disease Management

Location

Salary Details

This salary was provided in the Job Posting.
$95,000-$105,000
Yearly Salary
This salary is within the average salary range of $70,000-$140,384 for this role in this location
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