QUALITY MANAGER / RN

Responsibilities

This RN / Quality Manager position is full time on-site position, offer full benefits and a convenient day shift. The Quality Coordinator RN is a registered nurse who functions in a market quality leadership role in Population Health. This role helps drive quality best practices in a collaborative effort with payers, providers, support staff, managed care, VBC leaders and administration. The Quality Coordinator RN will participate in quality improvement initiatives, develop recommendations for quality remediation plans and create tools and databases to capture relevant data for their respective region. The QCRN will also be a leader for their local quality support team, with attention to apportioning responsibilities for quality support staff across their respective market. This role will also develop collaborative payer relationships to maximize resource utilization for patient care. Additionally, they will track quality performance on an ongoing basis with dissemination of performance metrics to key stakeholders (clinics, providers, administration) as a part of their leadership within a matrix relationship. The Quality Coordinator RN will be responsible for driving performance across plan metrics as outlined by the respective plans, optimize patient outcomes and system utilization, focus on STARS and HEDIS performance/metrics and help with MIPS measures. Additionally, the QCRN will help support quality staff competency and optimize clinic quality workflows within their region.

Job Duties/Responsibilities:

• STARS/HEDIS and MIPS Performance
  • Participate in the development of an annual work plan for improvement of STAR ratings, HEDIS and MIPS capture/performance from the position of the leader of the market quality team.
  • Support system efforts that may include MSO initiatives, new payer contracts, and risk initiatives.
  • Help create and support quality-based clinic workflows geared towards capturing gaps in care (chart scrubbing, pre-charting, huddles, Patient Care Conferences (PCCs)
  • Support provider reviews of performance on a regular cadence (monthly preferable).
  • Participate in payer meetings, create appropriate JOCs with payers.
  Analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies
• Optimizing HCC capture and appropriately maximizing RAF
  • Education of clinical staff concerning HCC capture and importance of RAF
  • Develop and implement strategies for maximization of attestation form completion.
  Optimize AWV completion and promote as an opportunity for completing HCC capture
• Longitudinal Care Coordination
  • Provide leadership of quality team in the ongoing development of quality and timely patient care across the care continuum
  • Develop collaborative relationships across the patient care spectrum in the pursuit of warm patient hand-offs and a seamless care experience.
  Leadership of RN Care Managers and Population Health Coordinators within a collaborative environment, to maximize longitudinal care of the patients.

Benefits for full and part time employees:

• Challenging and rewarding work environment
• Competitive Compensation & Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• Career development opportunities within UHS and its 300+ Subsidiaries!

About Universal Health Services

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Qualifications

Requriements:

• Graduation from an accredited nursing education program.
• Actively licensed by the worked in State to practice as a Registered Nurse.
• Minimum of 5 years of associated Population Health/Quality experience within the health care industry, preferably ambulatory based and includes experience with HEDIS/STARS and MIPS
• Bachelor's Degree
• Master's Degree, preferred

Knowledge:

• Motivational Intervening
• Shared Decision Making
• Patient Centered Medical Home principles and Population Health principles (including care management, HEDIS/STARS and MIPS)
• Must demonstrate knowledge and ability to work effectively with all levels of personnel
• Knowledge of medical documentation requirements for meeting quality incentives
• Demonstrates awareness of and use of appropriate body mechanics

Skills:

• Critical thinking, problem solving
• Must possess excellent communication skills and demonstrate team leadership and interpersonal skills

Abilities:

• Must have the ability to problem solve and think critically
• Ability to work both independently and support a regional quality team
• Operate within the concept of patient centered care
• Ability to coach and mentor clinical and non-clinical staff

Equipment Operated:

• Standard office equipment (laptop computer, fax, copier scanner)
• Pop Health/EMR software

Work environment:

• Office or outpatient medical office setting
• Works in a well-lighted, OSHA Standard environment
• May be exposed to infectious and contagious diseases and bloodborne pathogens
• May be in contact with patients under a wide variety of circumstances
• Local ND domestic travel
• Occasionally subject to irregular hours

May be required to wear personal protective equipment as necessary EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.