RN -Regulatory Quality Clinical Care

About the role

Build your Career. Make a Difference. Presbyterian is hiring a skilled Regulatory Quality RN Clinical Care-Intermediate How you grow, learn and thrive matters here. - Educational and career development options, including tuition and certification reimbursement, scholarship opportunities - Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern) - Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions) - Malpractice liability insurance - Loan forgiveness through the New Mexico Higher Education Department - EPIC electronic charting system Type of Opportunity: Full time FTE: 1.00 Job Exempt: Yes Work Shift: Days (United States of America)

Responsibilities

• Presbyterian is seeking a Regulatory Quality RN Clinical Care-Intermediate
• Some key responsibilities include:
• With guidance, reviews, responds to, and researches complaints related to quality of medical care utilizing a high level of knowledge and skill in nursing practice in order to discern the key factors in each case to ensure that all quality of care issues are identified and addressed.
• Provides referrals, as appropriate to the case, to correlating PHP entities including but not limited to: Legal, Risk Management, Behavioral Health QOCC Team, Provider Network Operations, Credentialing, Critical Incidents Teams, or Care Coordination.
• Perform Physical Health QOCC Case Management-all levels
• Conduct Practice Pattern Reviews
• Manage PIPs (Performance Improvement Plan)
• Conducts Medical Record Review (MRR)
• Prepare and Present Medical Director Reviews
• Attend Weekly Medical Records Huddle
• Writes QOCC Correspondence/Letters
• With guidance, writes and presents QOCC case summaries to PHP's Physical Health Professional Practice Evaluation Committee (PH PPEC).
• With guidance, manages and communicates PH PPEC recommendations including but not limited to: Practice Pattern Reviews, Performance Improvement Plans, and/or Recommendations for Terminations, Suspensions, or Admissions Holds.
• Other duties as assigned.

Requirements

• Bachelors in Nursing
• Five years hospital nursing experience
• Current NM RN License
• Skills in Outlook, Word, Excel, and Power Point
• Proficiency in writing or professional correspondence
• Preferred:
• Critical Care experience
• Complaint Management experience
• Quality Improvement experience
• Care Coordination/Case Management experience
• We're all about well-being, starting with yours.
• Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.
• Learn more about our employee benefits.
• About Presbyterian Healthcare Services
• Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
• AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
• Compensation Disclaimer
• The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
• We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

Benefits

Additional Information

Location Address: 9521 San Mateo NE Albuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $58,073.60 Maximum Offer $88,670.40

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