Lead Nurse for Quality Enhancement Initiatives

2 months ago

San Francisco, California, United States Central California Alliance for Health Full time

We are excited to present an opportunity to become a part of the Central California Alliance for Health as a Lead Nurse for Quality Enhancement Initiatives within the Quality Improvement and Population Health Department.

KEY RESPONSIBILITIES

Under the supervision of the Clinical Safety Quality Manager, this role involves:

  • Formulating, overseeing, and assessing a comprehensive healthcare strategy that aligns with Department of Health Care Services (DHCS) standards, collaborating with internal teams and network providers to advocate for evidence-based practices and enhance member health outcomes.
  • Working alongside the Quality Improvement and Population Health Department Team and other divisions to assess and report on observed and/or measured trends in both individual and group provider performance.
  • Engaging in local, regional, and state audits and initiatives aimed at measuring, analyzing, and enhancing member health outcomes.
  • Assessing patient safety and quality concerns, and effectively communicating findings to internal stakeholders, network providers, and community partners.
  • Providing training and mentorship to Quality Improvement Nurses focused on Facility Site Review.
ABOUT OUR TEAM

Our team is dedicated to ensuring both quality and safety in the medical and behavioral health care services provided to our members.

ESSENTIAL QUALIFICATIONS

For a detailed overview of the position and its requirements, please refer to the full job description.
  • Knowledge Required:
    • Clinical nursing principles and practices.
    • Managed care systems, the Medi-Cal program, and associated policies.
    • Healthcare delivery systems and medical practice operations.
    • Healthcare quality improvement principles and practices.
    • Proficiency in Windows-based PC systems and Microsoft Office Suite including Word, Excel, PowerPoint, and Outlook.
    • Research, analysis, and reporting methodologies.
  • Skills Required:
    • Ability to evaluate medical records and other healthcare data.
    • Conducting and coordinating audits, analyzing results, and making actionable recommendations.
    • Identifying issues, conducting research, gathering and analyzing information, and formulating logical conclusions.
    • Synthesizing extensive data and developing actionable plans to address provider issues and respond to audits.
    • Interpreting, applying, and explaining policies, regulations, terms, and procedures.
    • Serving as a subject matter expert in Facility Site Review activities.
  • Education and Experience:
    • Current, unrestricted Registered Nurse license issued by the State of California.
    • Certification as a Certified Site Reviewer as defined by DHCS.
    • Certification as a Certified Master Trainer issued by DHCS within one year of hire.
    • Bachelor's degree with a minimum of five years of Registered Nurse experience, including at least three years in acute or primary care with a focus on preventative care, and a minimum of two years in Quality Improvement; or an equivalent combination of education and experience.
ADDITIONAL INFORMATION
  • This position operates in a hybrid work environment, with remote interviews conducted via Microsoft Teams.
  • While some employees may work fully remotely, attendance at quarterly company-wide events or departmental meetings is expected.
  • In-office or community presence may be required based on business needs, which will be discussed during the interview process.
COMPENSATION

The compensation range for this position varies by location, with the actual salary determined by the organization's compensation philosophy, analysis of the selected candidate's qualifications, and other relevant factors.

OUR BENEFITS

Available to all regular employees working over 30 hours per week, with some benefits offered on a pro-rated basis for part-time employees.
  • Medical, Dental, and Vision Plans.
  • Generous Paid Time Off.
  • 12 Paid Holidays annually.
  • 401(a) Retirement Plan.
  • 457 Deferred Compensation Plan.
  • Comprehensive Health and Wellness Program.
  • Onsite EV Charging Stations.
ABOUT US

We are a dedicated team of over 500 employees committed to our mission of providing accessible, quality healthcare guided by local innovation. Our work impacts the community positively, and we take pride in making a difference every day.

Join us at Central California Alliance for Health, where you will be part of a respectful, diverse, and professional culture that empowers you to excel in your role. As a regional non-profit health plan, we serve members across multiple counties. We are an equal opportunity employer, and qualified applicants will be considered for employment without regard to various protected statuses. We do not provide sponsorship for employment. Applicants must be authorized to work in the United States on a full-time basis.

  • Quality Engineering Manager for FedNow Initiative

    3 weeks ago

    San Francisco, California, United States Federal Reserve System Full time

    Company Federal Reserve Bank of Boston is at the forefront of delivering a comprehensive suite of payment services to financial institutions through innovative solutions such as FedLine Solutions, FedNowSM, Fedwire, National Settlement Service (NSS), FedCash, FedACH, and Check Services. We are embarking on a strategic transformation to evolve our...

  • Travel Nurse RN Lead

    2 weeks ago

    San Francisco, California, United States Lead Health Full time

    Lead Healthstaff Travel Nurse RN Job OpportunityWe are seeking a skilled Labor & Delivery Registered Nurse (RN) to join our team at a top healthcare facility in San Francisco, California. As a Travel Nurse RN, you will have the opportunity to work in a dynamic and fast-paced environment, providing high-quality patient care and making a positive impact on the...

  • Enhanced Care Management Director

    4 weeks ago

    San Francisco, California, United States Bayview Hunters Point Foundation Full time

    Job Title: Enhanced Care Management DirectorBayview Hunters Point Foundation is seeking an experienced Enhanced Care Management Director to lead our team in providing high-quality care management services to our clients. As a key member of our leadership team, you will be responsible for managing the day-to-day operations of our Enhanced Care Management...

  • Strategic Initiatives Coordinator

    3 weeks ago

    San Francisco, California, United States Q-Cells Full time

    Position Overview We are seeking a dedicated and detail-oriented Strategic Initiatives Coordinator to join our Strategy & Operations division at Q-Cells. This newly established role will focus on driving various operational excellence initiatives, due diligence efforts, and process enhancements within the organization. The successful candidate will...

  • Quality Management Nurse

    4 weeks ago

    San Francisco, California, United States Alignment Healthcare Full time

    Job Title: Quality Management NurseAlignment Health is seeking a Quality Management Nurse to join our team. As a Quality Management Nurse, you will play a critical role in ensuring the quality of care provided to our members.Responsibilities:Develop and implement quality improvement initiatives to enhance patient care and outcomes.Conduct regular audits and...

  • Chief of Staff

    4 weeks ago

    San Francisco, California, United States Aduro Advisors Full time

    About the RoleAduro Advisors is seeking a highly skilled and experienced Chief of Staff to join our team. As a key member of our leadership team, you will be responsible for developing and executing a comprehensive client engagement strategy that drives business growth and enhances our reputation as a leading fund administrator.Key ResponsibilitiesDevelop...

  • Quality Assurance Nurse

    1 week ago

    San Francisco, California, United States Self-Help For The Elderly Full time

    Job Summary:The Quality Assurance Nurse is responsible for evaluating clinical practices within Self-Help Home Care & Hospice and implementing changes for improvement. This role requires a Registered Nurse with current licensure to practice professional nursing in the state and previous experience in hospice/home health setting. The ideal candidate will...

  • Tech Lead for Code Quality Enhancement

    2 weeks ago

    San Jose, California, United States HireIO Inc Full time

    About the TeamHireIO Inc's Quality Technology Team is dedicated to delivering high-quality products and tools throughout the software engineering lifecycle. Our team focuses on providing effective quality solutions to businesses, helping them build quality technology capabilities.Job DescriptionWe are seeking a Tech Lead, Code Quality Improvement to join our...

  • Senior Project Lead for Strategic Initiatives

    2 days ago

    San Francisco, California, United States IFG - International Financial Group Full time

    We are seeking a highly skilled Senior Project Lead for Strategic Initiatives to join our team at IFG - International Financial Group. This is an exciting opportunity to contribute to impactful projects and initiatives while honing your skills in project management, data analysis, and brand reputation.As a Senior Project Lead, you will play a key role in...

  • Quality Improvement Nurse

    3 weeks ago

    San Francisco, California, United States Central California Alliance for Health Full time

    Quality Improvement Nurse - FSR (RN) Job DescriptionWe are seeking a highly skilled Quality Improvement Nurse - FSR (RN) to join our team at Central California Alliance for Health. As a Quality Improvement Nurse - FSR (RN), you will play a critical role in developing, managing, and measuring a comprehensive healthcare strategy that aligns with Department of...

  • Senior Quality Improvement Nurse

    3 weeks ago

    San Francisco, California, United States Central California Alliance for Health Full time

    Senior Quality Improvement NurseWe are seeking a highly skilled Senior Quality Improvement Nurse to join our team at Central California Alliance for Health. As a Senior Quality Improvement Nurse, you will play a critical role in developing and implementing comprehensive healthcare strategies to improve member health outcomes.Key Responsibilities:Develop and...

  • Labor & Delivery Registered Nurse (RN) Opportunity with Lead Health

    3 days ago

    San Francisco, California, United States Lead Health Full time

    We are seeking a skilled Labor & Delivery Registered Nurse (RN) to join our team at Lead Health. As a Travel RN, you will have the opportunity to make a positive impact on patient care while enjoying a high-paying and flexible lifestyle with low stress and full benefits.At Lead Health, we understand the importance of work-life balance and offer our Travelers...

  • Quality Assurance Nurse Specialist

    2 weeks ago

    San Francisco, California, United States Self-Help For The Elderly Full time

    Job Title: Quality Assurance NurseAt Self-Help for the Elderly, we are seeking a highly skilled Quality Assurance Nurse to join our team. As a Quality Assurance Nurse, you will play a critical role in evaluating clinical practices within our Home Care and Hospice department and implementing changes for improvement.Key Responsibilities:Prospectively review...

  • Senior Quality Improvement Nurse

    4 weeks ago

    San Francisco, California, United States Central California Alliance for Health Full time

    About the RoleWe are seeking a highly skilled Senior Quality Improvement Nurse to join our Quality Improvement and Population Health Department. As a key member of our team, you will play a critical role in developing and implementing comprehensive healthcare strategies to improve member health outcomes.Key ResponsibilitiesDevelop, manage, and measure...

  • Quality Improvement Nurse

    3 weeks ago

    San Francisco, California, United States Central California Alliance for Health Full time

    About the RoleWe are seeking a highly skilled Quality Improvement Nurse to join our team at Central California Alliance for Health. As a Quality Improvement Nurse, you will play a critical role in developing and implementing comprehensive healthcare strategies to improve member health outcomes.Key ResponsibilitiesDevelop and Manage Healthcare Strategies:...

  • Staff UX Researcher

    3 days ago

    San Francisco, California, United States Match Group Full time

    Job SummaryWe are seeking a highly experienced Staff UX Researcher to join our team at Match Group. As a Staff UX Researcher, you will lead large-scale, complex research initiatives, collaborating closely with cross-functional teams to deliver high-quality research insights that drive strategic product decisions, inform our product roadmap, and help us...

  • Quality Improvement Nurse

    3 weeks ago

    San Francisco, California, United States Central California Alliance for Health Full time

    About the RoleWe are seeking a highly skilled Quality Improvement Nurse - FSR (RN) to join our team at Central California Alliance for Health. As a key member of our Quality Improvement and Population Health Department, you will play a critical role in developing and implementing comprehensive healthcare strategies to improve member health outcomes.Key...

  • Travel Cardiologist Specialist

    2 weeks ago

    San Francisco, California, United States Nurse First Full time

    Job Title: Travel Echo TechnologistNurse First is seeking a skilled Echo Technologist for a travel assignment in a dynamic healthcare setting.Job SummaryThis is a fantastic opportunity for a dedicated and detail-oriented Echo Technologist to join our team and contribute to the delivery of high-quality patient care.ResponsibilitiesPerform echocardiography...

  • International Strategic Initiatives Director

    1 month ago

    San Francisco, California, United States Charles Schwab Full time

    Job SummaryThe Director of International Strategic Initiatives will play a pivotal role in shaping the company's global growth strategy, driving innovation, and delivering exceptional results. This senior leadership position will oversee the development and execution of strategic initiatives that enhance the company's international presence, drive revenue...

  • Senior Director Quality Lead

    2 weeks ago

    San Francisco, California, United States Pendulum Full time

    Pendulum is Revolutionizing the Microbiome IndustryPendulum is a pioneering company that is leading a global revolution to improve physical and mental health by understanding, restoring, and enhancing the human microbiome.Our research has shown that the microbiome plays a critical role in various aspects of our lives, including metabolism, diabetes,...