Central California Alliance for Health
Senior Quality Improvement Nurse (RN) - Facility Site Review
Central California Alliance for Health, Santa Cruz, California, us, 95061
Senior Quality Improvement Nurse (RN) - Facility Site Review
Location:
Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, CaliforniaWe have an opportunity to join the Alliance as a Senior Quality Improvement Nurse (RN) - Facility Site Review in the Quality Improvement and Population Health Department.WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Clinical Safety Quality Manager, this position:Develops, manages, and measures a comprehensive healthcare strategy in alignment with Department of Health Care Services (DHCS) standards of care and in collaboration with internal stakeholders and network providers to promote evidence-based practices and improve member health outcomesCollaborates with the Quality Improvement and Population Health Department Team and other departments to evaluate and report observed and/or measured trends in individual and group provider performanceParticipates in local, regional, and state audits and initiatives to measure, analyze and improve member health outcomesEvaluates patient safety and quality issues and communicates findings to internal stakeholders, network providers, and community partnersTrains and mentors Quality Improvement Nurses-Facility Site ReviewABOUT THE TEAM
We are comprehensive and address both quality and safety of medical and behavioral health care provided to our members.WHAT YOU'LL NEED TO BE SUCCESSFUL
Knowledge of:Principles and practices of clinical nursingManaged care, the Medi-Cal program, and related policyMedical practice operations and healthcare delivery systemsPrinciples and practices of healthcare quality improvementProficiency with Windows based PC systems and Microsoft Word, Excel, PowerPoint, and OutlookMethods and techniques of research, analysis, and reportingAbility to:Evaluate medical records and other health care dataConduct and coordinate audits, analyze audit results, and make recommendations for actionIdentify issues, conduct research, gather and analyze information and data, reach logical and sound conclusions, and make recommendations for actionSynthesize large amounts of data and develop actionable plans to address provider issues and respond to auditsInterpret, apply, and explain policies, regulations, terms, and proceduresAct as a FSR subject matter expert and provide guidance regarding the more complex FSR activitiesEducation and Experience:Current, unrestricted license as a Registered Nurse issued by the State of CaliforniaCurrent certification as a Certified Site Reviewer as defined by DHCSPossession and continued maintenance of Certified Master Trainer certification issued by DHCS within one year of hireBachelor's degree and a minimum of five years of experience as a Registered Nurse which included a minimum of three years of acute care or primary care experience with an emphasis on preventative care and a minimum of two years of experience in Quality Improvement (a Master's degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying.OTHER INFORMATION
We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.The full compensation range for this position is listed by location below:Santa Cruz County Pay Range:
$99,139 - $158,642 USDMerced County Pay Range:
$90,213 - $144,352 USDMonterey County Pay Range:
$99,139 - $158,642 USDMariposa County Pay Range:
$90,213 - $144,352 USDSan Benito County Pay Range:
$99,139 - $158,642 USDOUR BENEFITS
Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.Medical, Dental and Vision PlansAmple Paid Time Off12 Paid Holidays per year401(a) Retirement Plan457 Deferred Compensation PlanRobust Health and Wellness ProgramOnsite EV Charging StationsABOUT US
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our
Fact Sheet .The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer.At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.Apply for Senior Quality Improvement Nurse (RN) - Facility Site Review
#J-18808-Ljbffr
Location:
Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, CaliforniaWe have an opportunity to join the Alliance as a Senior Quality Improvement Nurse (RN) - Facility Site Review in the Quality Improvement and Population Health Department.WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Clinical Safety Quality Manager, this position:Develops, manages, and measures a comprehensive healthcare strategy in alignment with Department of Health Care Services (DHCS) standards of care and in collaboration with internal stakeholders and network providers to promote evidence-based practices and improve member health outcomesCollaborates with the Quality Improvement and Population Health Department Team and other departments to evaluate and report observed and/or measured trends in individual and group provider performanceParticipates in local, regional, and state audits and initiatives to measure, analyze and improve member health outcomesEvaluates patient safety and quality issues and communicates findings to internal stakeholders, network providers, and community partnersTrains and mentors Quality Improvement Nurses-Facility Site ReviewABOUT THE TEAM
We are comprehensive and address both quality and safety of medical and behavioral health care provided to our members.WHAT YOU'LL NEED TO BE SUCCESSFUL
Knowledge of:Principles and practices of clinical nursingManaged care, the Medi-Cal program, and related policyMedical practice operations and healthcare delivery systemsPrinciples and practices of healthcare quality improvementProficiency with Windows based PC systems and Microsoft Word, Excel, PowerPoint, and OutlookMethods and techniques of research, analysis, and reportingAbility to:Evaluate medical records and other health care dataConduct and coordinate audits, analyze audit results, and make recommendations for actionIdentify issues, conduct research, gather and analyze information and data, reach logical and sound conclusions, and make recommendations for actionSynthesize large amounts of data and develop actionable plans to address provider issues and respond to auditsInterpret, apply, and explain policies, regulations, terms, and proceduresAct as a FSR subject matter expert and provide guidance regarding the more complex FSR activitiesEducation and Experience:Current, unrestricted license as a Registered Nurse issued by the State of CaliforniaCurrent certification as a Certified Site Reviewer as defined by DHCSPossession and continued maintenance of Certified Master Trainer certification issued by DHCS within one year of hireBachelor's degree and a minimum of five years of experience as a Registered Nurse which included a minimum of three years of acute care or primary care experience with an emphasis on preventative care and a minimum of two years of experience in Quality Improvement (a Master's degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying.OTHER INFORMATION
We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.The full compensation range for this position is listed by location below:Santa Cruz County Pay Range:
$99,139 - $158,642 USDMerced County Pay Range:
$90,213 - $144,352 USDMonterey County Pay Range:
$99,139 - $158,642 USDMariposa County Pay Range:
$90,213 - $144,352 USDSan Benito County Pay Range:
$99,139 - $158,642 USDOUR BENEFITS
Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.Medical, Dental and Vision PlansAmple Paid Time Off12 Paid Holidays per year401(a) Retirement Plan457 Deferred Compensation PlanRobust Health and Wellness ProgramOnsite EV Charging StationsABOUT US
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our
Fact Sheet .The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer.At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.Apply for Senior Quality Improvement Nurse (RN) - Facility Site Review
#J-18808-Ljbffr