Clinical Quality Manager (RN)

Company: The Execu - Search Group
Location: New York
Posted on: January 16, 2022

Job Description:

A healthcare organization in New York City is actively seeking a dynamic and experienced Registered Nurse (RN) to join their staff as a -Clinical Quality Manager. In this role, the -Clinical Quality Manager (RN) will -oversee and ensure Quality Assurance data accuracy and reporting, and will support the overall Quality strategy.

Responsibilities

The -Clinical Quality Manager (RN) will:
Analyze data and reports and utilize data-driven methodologies to identify opportunities for improvement
Promote comprehensive understanding of HEDIS/Stars measures, barriers, and opportunities to key internal audiences
Oversee quality program performance for one or more health plan products (MLTC or Medicare)
Monitor HEDIS / Stars gap closures
Develop performance improvement initiatives to improve HEDIS / Stars measures and/or other identified quality improvement measures
Serve -as day-to-day contact for CMS external auditor
Plan and facilitate meetings to design performance improvement initiatives with other Quality team members
Provide guidance to staff preparing analysis and reports for Quality
Advance quality improvement initiatives and Quality team goals across the board, working with other business units and utilizing indirect leadership to accomplish objectives
Guide -planning and implementation for supplemental data collection process, working with internal and external stakeholders
Drives annual HEDIS chart retrieval process, such as: medical record retrieval, MRR/overreads, claims research, provider outreach, and issue resolution
Qualifications BSN
Active New York State Registered Nurse license
3-5+ years' experience with -quality performance improvement, including HEDIS or Stars measures
2 years of experience with direct HEDIS involvement, including hybrid medical record review
Experience with healthcare claims data
Experience managing quality improvement campaigns
Data-driven mindset and high comfort level with metrics
Knowledge of Microsoft Office

Keywords: The Execu - Search Group, New York , Clinical Quality Manager (RN), Executive , New York, New York