Quality Assurance Nurse Manager

Quality Assurance Nurse Manager Overview

• The Quality Assurance Nurse Manager oversees wellness and quality assurance initiatives within the organization.
• Develop goals and outcomes using HEDIS specifications for quality improvement and corrective action plans.
• Collaborate with providers to address quality-of-care concerns and enhance performance measures.
• Supervise and provide clinical oversight to Registered Nurses and Health Educators.
• Educate members on chronic conditions and promote healthier lifestyle behaviors.
• Participate in health fairs, screenings, and outreach events to support community wellness.
• Engage in seasonal vaccination and testing initiatives as required.
• Analyze data, identify trends, and recommend quality enhancements to business leads.
• Hybrid work schedule provides flexibility and work-life balance.

Quality Assurance Nurse Manager Key Responsibilities & Duties

• Coordinate and develop quality improvement goals using HEDIS specifications.
• Review charts and population-based data for quality improvement processes.
• Track and trend reported quality-related issues to identify gaps in care.
• Serve as a clinical liaison between the organization and providers on quality concerns.
• Supervise and oversee activities of Wellness RNs and Health Educators.
• Educate members on acute and chronic conditions to promote healthier behaviors.
• Participate in vaccination, testing, and outreach events as needed.
• Collaborate with business leads to recommend quality enhancements based on data analysis.
• Perform additional duties and projects as assigned by management.

Quality Assurance Nurse Manager Job Requirements

• Valid New York State Registered Nurse (RN) license required; Bachelor’s degree in Nursing preferred.
• Minimum three years of quality improvement experience and two years of management experience.
• Strong clinical assessment, patient education, and motivational interviewing skills.
• Knowledge of HEDIS specifications and NCQA standards preferred.
• Intermediate computer literacy and proficiency in Microsoft Outlook, Word, and Excel preferred.
• Bilingual in Spanish preferred; valid NYS driver’s license preferred.
• Ability to work flexible hours, including evenings and weekends as needed.
• Experience in ambulatory care, community health care, or medical/surgical nursing.
• Excellent communication skills for nurse-physician interactions.