Clinical Nurse Quality Manager

DataStaff, Inc is in need of a Clinical Nurse Quality Manager for a long-term contract opportunity for one of our direct clients in Raleigh, NC.

*This position is hybrid; 2x/week on site

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.
• 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
• 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.

This opportunity is available as a W2 position with a competitive benefits package . DataStaff, Inc. offers medical, dental and vision coverage options as well as paid vacation, sick and holiday leave. As many of our opportunities are long-term, we also have a 401K program available for employees after 6 months.