Providence is calling aManager Quality Management, RN ( Full Time / Day Shift ) to our Facey locationin Mission Hills, CA.
In this position youwill:
- Work directly with the Medical Groups and Foundationsand is responsible for integration and delivery of Quality Management MSOfunctions for the Medical Groups and Foundations, in compliance withdelegated and regulatory requirements. Lead the integration of MSO QualityManagement programs, developing and implementing standard workflows acrossmultiple delivery models, local markets, and diverse populations acrossthe Southern CA market. Responsible for performance in the areas of QMrelated issues, data management/submission, Appeals & Grievances, ICEReporting, CAPs, Pay for Performance/CMS 5 Star, Patient SatisfactionSurvey process and reporting, CAPG Standards of Excellence Surveypreparation and submission. Create a scalable organizational structure tosupport the medical groups through growth, including acquisitions ofpatient populations and provider groups. Supervise the dailyactivities of the Quality Management Department Staff and the Appeals& Grievance Coordinators to assure accurate and timely response tohealth plans.
- Direct the oversight of reporting, compliance,efficiency and accuracy of the QM process as delegated by each PSA withthe health plans, including quality metrics management and reporting,event reporting, appeals and grievances, and patient safety in theambulatory setting, in accordance with our Program Plan, policies andprocedures. Assist in developing and implementing a robust set ofactionable quality reports and tools such as the MDX Registry anddocumentation of workflows to improve quality metrics and patient outcome.Instrumental in developing and implementing tools to improveaccountability and patient safety, such as High Reliability Organization(HRO). Responsible for compliance with health plans/NCQA/DMHC health carequality mandates and for the preparation and submission of audits andrequired health plan reports. Collaborate with Providence Health andServices (PHSCA) Medical Groups and Foundations leadership on all auditsresults and needed corrective action plans.
- Effectively drive consistent high quality care deliveryin a rapid growth environment and across multiple ambulatory care deliverysystems (employed, contracted and IPA) and various risk levels. Leadintegration across the MSO in delivering QM functions cross multiplemedical groups. Drive rapid process improvement to increase organizationalefficiency. Effectively use data to evaluate opportunities, supportinterventions and measure results. Instrumental in the evaluation,selection process and implementation of technology solutions to support QMfunctions. Lead organizational and cultural transformation, and inspiresothers to create highly effective teams. Demonstrate effectiveness andability to work in partnership across reporting and organizationalstructures, including hospitals, partners and medical groups in SouthernCA.
Required qualificationsfor this position include:
- RN graduate of an accreditedschool of nursing with a current California RN license.
- Bachelor's in Nursing.
- Minimum three to five yearsexperience of clinical nursing in an acute care setting with strongemphasis on medical/surgical nursing or specialty area.
- Minimum two years of ambulatorycare experience.
- Experience in developingeducational programs and procedures required.
- Knowledge of Title XXII, NCQA,AAAHC requirements and standards, CDC and infection control standards,building codes, fire department safety standards, OSHA requirements (TitleVIII).
- Must possess excellent teachingskills including presentation.
- Experience with HMOs and healthplans highly recommended.
Preferred qualificationsfor this position include:
- Master's degree in Nursing or Education.
- Minimum two years of hospital experience.
- Quality Assurance/Improvement experience desirable.
About the organizationyou will serve:
Facey Medical Group is a
multi-specialty medical group with over 160 physicians providing care to the
growing population in the North & East regions of Los Angeles & Ventura
Counties. Twelve medical clinics, including two urgent care centers and
dedicated women's centers, are located across the San Fernando, Santa Clarita
and Simi Valleys. The group began as a single medical practice over 90 years
ago. Facey is part of
Providence Health & Services, an integrated, not-for-profit 5-state network
of hospitals, care centers, medical clinics, affiliated services and
educational facilities spanning from California to Alaska.
We offer a full comprehensive range of benefits - see our website for details
As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.
Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Quality Nursing
Location: California-Santa Monica
Req ID: 147777