Wellness Quality Assurance Nurse Manager

Overview

• Lead quality assurance programs to enhance healthcare delivery and community wellness initiatives in a dynamic, hybrid work environment.
• Provide clinical oversight to Wellness RNs and Health Educators, ensuring compliance with healthcare standards and promoting impactful outcomes.
• Collaborate with healthcare providers to address care gaps and optimize chronic condition management strategies effectively.
• Analyze healthcare data to identify trends, implement quality improvement measures, and drive evidence-based decision-making.
• Engage in community outreach initiatives, including health fairs and screenings, to enhance public health awareness and education.
• Support vaccination campaigns and health testing programs to improve overall community health outcomes.
• Contribute to the development and execution of corrective action plans aligned with organizational quality improvement goals.

Key Responsibilities & Duties

• Coordinate and implement quality improvement initiatives using HEDIS specifications to achieve healthcare objectives.
• Review patient charts and population data to ensure compliance with healthcare standards and identify areas for improvement.
• Monitor and address care gaps for chronic conditions and mental health concerns in collaboration with healthcare providers.
• Supervise and guide Wellness RNs and Health Educators in executing quality assurance projects effectively.
• Educate members on health conditions and promote healthier lifestyle choices through targeted outreach programs.
• Participate in community health initiatives, including outreach events and screenings, to promote wellness.
• Analyze quality-related issues, recommend enhancements, and implement corrective actions to improve care delivery.
• Serve as a clinical liaison to address quality-of-care concerns and foster collaboration among healthcare providers.

Job Requirements

• Valid Registered Nurse (RN) license required; Bachelor’s degree in Nursing preferred.
• Minimum one year of quality improvement experience and managerial responsibilities in a healthcare setting.
• Proficiency in clinical assessment, patient education, and motivational interviewing techniques.
• Familiarity with HEDIS specifications and NCQA standards is highly desirable.
• Intermediate computer skills, including proficiency in Microsoft Outlook, Word, and Excel.
• Bilingual in Spanish and possession of a valid driver’s license are preferred qualifications.
• Ability to work flexible hours, including evenings and weekends, as required.
• Associate of Applied Science (AAS) degree required; advanced education is advantageous.