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Medicare HEDIS Quality RN Supervisor

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Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.

What you’ll do:

The Quality Improvement Nursing Supervisor is responsible for the day-to-day operations of the Quality Improvement (QI) Department nursing team. The supervisor will have direct daily interactions with all aspects of clinical staffing to include, but not limited to, ensuring nursing coverage, daily assignments, monitoring of long term and short-term clinical projects, investigation and resolution processes for their respective Quality Improvement function(s) such as: Quality of Care (QoC), delegation oversight, accreditation and regulatory requirements, HEDIS, and member safety. In addition, the supervisor works collaboratively with QI leadership to support clinical QI plan expectations including key performance indicators, continual learning, and quality assurance. In addition, the supervisor works collaboratively with other teams/departments in relationship to these requirements. The supervisor precepts and oversees onboarding of all new nurses to the department.

What awaits you:

  • Work-life balance - This is a remote role
  • Medical, Dental, and Vision Insurance.
  • 403B Savings Plan w/employer contribution.
  • Paid Time off & Paid holidays.
  • Employee and Dependent Tuition assistance benefits.
  • Health and wellness programs and MORE

What you’ll bring:

  • Requires an Associate’s Degree in Nursing.Bachelor’s Degree preferred.
  • Requires a minimum of five years of clinical experience. Must have experience with conducting and monitoring the medical record review process. Three Years Management/Supervisory or equivalent work experience required. Must have experience with HEDIS measures and/or Star Ratings. Knowledge of Medicare and Federal regulations is required.
  • RN licensure in the state of Maryland.
  • Requires working knowledge of National Committee for Quality Assurance (NCQA) standards, HEDIS, delegation oversight, QoC, audit, monitoring, and evaluation processes.
  • Requires a working knowledge of Microsoft Office and Excel. Also, requires a minimum of five years of clinical nursing experience

JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins

Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

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