Senior Quality Assurance Manager Nurse

Provide strategic and operational leadership to registered nurses and allied clinical staff Oversee daily operations, ensuring efficient workflows and appropriate staffing levels Participate in coordinating and developing Quality Improvement initiatives and monitor performance metrics and outcomes Review generic charts and other population-based data to identify trends, gaps, and opportunities for quality improvement across chronic conditions for provider groups and individual providers, then address them Serve as a clinical liaison between the Fund and Providers on quality-of-care concerns (HEDIS and other Performance Measures) Review performance, evaluate effectiveness, analyze data, identify trends, and collaborate with business leads to recommend enhancements Engage Fund Registered Nurses (RN), Health Educators (HE), and Social Workers (SW) in quality assurance projects, such as outreach to members with gaps in care Assist Medical Director in hiring, recruiting, onboarding and evaluation of clinical staff Provide supervision, mentoring, coaching, and clinical oversight of all Wellness clinical staff to strengthen competencies. Educate members regarding acute and chronic conditions and promote healthier lifestyle behaviors. Participate in seasonal vaccination and other types of testing as needed. Participate in Health Fairs, Screenings, and Outreach Events in New York City and outer borough locations as needed Perform additional duties and projects, as assigned by management Ability to work flexible hours including evenings and weekends as needed Requisition # 7506 # of openings 1 Employment Type Full time Position Status Permanent Category Non-Bargaining Workplace Arrangement Hybrid Fund 1199SEIU National Benefit Fund Job Classification Exempt Responsibilities Provide strategic and operational leadership to registered nurses and allied clinical staff Oversee daily operations, ensuring efficient workflows and appropriate staffing levels Participate in coordinating and developing Quality Improvement initiatives and monitor performance metrics and outcomes Review generic charts and other population-based data to identify trends, gaps, and opportunities for quality improvement across chronic conditions for provider groups and individual providers, then address them Serve as a clinical liaison between the Fund and Providers on quality-of-care concerns (HEDIS and other Performance Measures) Review performance, evaluate effectiveness, analyze data, identify trends, and collaborate with business leads to recommend enhancements Engage Fund Registered Nurses (RN), Health Educators (HE), and Social Workers (SW) in quality assurance projects, such as outreach to members with gaps in care Assist Medical Director in hiring, recruiting, onboarding and evaluation of clinical staff Provide supervision, mentoring, coaching, and clinical oversight of all Wellness clinical staff to strengthen competencies. Educate members regarding acute and chronic conditions and promote healthier lifestyle behaviors. Participate in seasonal vaccination and other types of testing as needed. Participate in Health Fairs, Screenings, and Outreach Events in New York City and outer borough locations as needed Perform additional duties and projects, as assigned by management Ability to work flexible hours including evenings and weekends as needed Qualifications A valid New York State Registered Nurse (RN) license is required; Bachelor’s degree required Minimum of six (6) years of nursing experience in ambulatory care, community health care, or medical/surgical settings, including at least three (3) years in quality improvement and four (4) years in management required Strong experience in clinical assessment, patient education, motivational interviewing, critical thinking, independent decision-making, quality assurance, and quality improvement Excellent nurse-physician communication, leadership, coaching, and team-building skills are required. Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA) Intermediate computer and digital literacy Basic proficiency in Microsoft Outlook, Word, and Excel is preferred #J-18808-Ljbffr 1199SEIU Benefit and Pension Funds