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Clinical Nurse Quality Manager
3 months ago
The North Carolina (NC) Department of Health and Human Services (DHHS), in collaboration with our partners, protects the health and safety of all North Carolinians and provides essential human services. North Carolina’s DHHS is one of the largest, most complex agencies in the state, and has approximately 18,000 employees. It is responsible for providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled and mentally ill, and helping poor North Carolinians achieve economic independence.
Within DHHS, the Division of Health Benefits (DHB) arranges and reimburses for health care services for the most vulnerable North Carolina residents. With a budget of nearly $14 billion, DHB serves 1.8 million low-income parents, children, seniors, and people with disabilities through the N.C. Medicaid and N.C. Health Choice for Children programs.
This position is hired through University Temporary Services (UTS) in collaboration with AHEC Area L. This contract position is required to report to Dix Campus in Raliegh 4 times per month while in UTS status.
Job Description:
The Nurse Quality Manager is responsible for the development, implementation, and monitoring of quality improvement initiatives aimed at enhancing healthcare outcomes for Medicaid beneficiaries. The Nurse Quality Manager will:
- Coordinate with key stakeholder teams inside and outside of DHB for enhancement of QI activities
- Identify opportunities for improvement based on analysis of data provided by Health Plans, the State, and other National Data sources
- Provide feedback to leadership on initiatives, KPIs, or potential cross-collaborative opportunities to inform on strategic planning
- Provide Clinical Quality Expertise on Policy Development of Quality Improvement Activities
- Manage relationships with healthcare stakeholders, offering evidence-based recommendations, resources, and ongoing feedback
- Work collaboratively as a Nurse Quality SME with other Business Units to enhance interoperability of Medicaid Quality activities
- Support QPHE leadership in developing person-centered, wholistic, and community friendly Performance Improvement Policies
- Communicate and Collaborate with Health Plans in enhancing member experience and outcomes
- Keep abreast of healthcare quality improvement trends, regulations, and best practices, ensuring compliance with standards such as NCQA, HEDIS, and CMS guidelines.
- Expected to lead 2-3 Quality Improvement activities per 12-month contract
- Participate and support other projects for QPHE
Skills:
- Able to clearly present to other SMEs and non-SMEs on Quality topics and education.
- Previous leadership experience in clinical or quality management.
- Advanced analytical capabilities, including the ability to interpret complex data sets and make data-driven strategic decisions.
- Excellent communication skills and ability to engage stakeholders at all organizational levels.
- Proficient in Microsoft Office Suite, especially Excel, PowerPoint, and Word. Familiarity with data analysis tools and software is a must.
Experience and Education:
- 2-3 years of Quality Improvement experience.
- Previous experience with HEDIS Measures.
- Advanced credit given for CPHQ or PMP or Six Sigma Yellow Belt certification.
- Preferred experience with Managed Care, Medicaid, Medicare, or Accountable Care Organizations.
- Preferred experience with understanding of Population Health interventions and outcomes.
- Minimum 5 years of Nursing Experience preferred. Degree-based recommendations below:
- ADN RN: 5 years of experience
- BSN: 3-5 years of experience
- MSN: 2-3 years of experience
Parameters for the position
- Temporary employees with University Temporary Services (UTS) are offered the opportunity to enroll in an ACA plan through NC State University if they are working in a position that is expected to last at least 3 months in duration and the position is 30 hours per week or more. An employee would be available to enroll immediately upon starting and coverage would start the 1st of the month following enrollment. Here is more information about the plan: Much more information is available upon request.
- An annual one-month furlough is required under UTS. Typically, furloughs are taken in the 11th month of employment. However, after six months of employment, if the employee’s supervisor agrees, the employee can transition to independent contractor status under Area L AHEC. Furlough is not required for independent contractors.
- As a temporary position through UTS, you would receive a W2 as you would technically be employed through NC State University. If you end up transitioning to the independent contractor status at the 6-month mark, you will then have a 1099 tax form at that time. Transitioning to the independent contractor status is optional. The hourly rate would not change if you decided to transition to the independent contractor status.
- This is intended to be a full-time position with the employee working about 40 hours per week. Hours per week are negotiable under the right circumstances.
- With some limitations, flexible schedules can be negotiated with supervisors.
- With some exceptions, this is a hybrid working arrangement, with in-person work being conducted on Dix Campus in Raleigh, North Carolina.
- All hires will have to pass a background check.
- This is a long-term temporary position with no specified end date.
