Nurse Navigation Quality Manager
Salary Range $105K - $115K
The Nurse Navigation program’s mission is focused on improving access to high-quality care, decreasing unnecessary healthcare expenditures, and improving the overall experience, satisfaction, and clinical outcomes for the populations we serve.
The Nurse Navigation Call Center is located in Lewisville, Texas in a state-of-the-art Integrated Communications Center (ICC). Using proprietary evidence based clinical decision software to immediately evaluate a patient’s current condition, we can match the patient with the appropriate resources to meet the patient’s unique healthcare needs. Our five-level triage system ensures we are delivering the right resource at the right time, in the right setting to achieve the right outcome at the right cost.
The Nurse Navigation program utilizes a national network of care coordinators and communication centers to link 911 call centers, nurse navigators, physicians, and mobile medical response teams together to provide world class care coordination, patient navigation and unplanned care services 24/7, 365 days a year.
Our team of nurse navigators provide superior care to support our partners who rely on our team to provide expertise of our large interprofessional workforce, and experience the value our national footprint, operational infrastructure, and innovative technologies creates. Our innovative programs are specifically designed to fill in gaps in services, provide economies of scale, improve operational efficiencies, and generate substantial savings with optimal return on investments for patients and payors.
Job Summary
The Quality Assurance Manager will develop, implement, and oversee quality improvement to ensure delivery of the highest quality patient care, optimal patient navigation, nurse navigation clinical productivity and continuity of care. Develop a conceptual framework for quality measurement and improvement activities across multiple clinical partners.
Produces performance reports, presentation decks, action plans and quality improvement projects for both internal and external stakeholders. This position will conduct customer workflow analysis and recommend education, quality and troubleshooting strategies, when needed, to help resolve customer issues.
ESSENTIAL FUNCTIONS/DUTIES
- Develop, implement, and oversee quality improvement to ensure delivery of the highest quality patient care, optimal patient navigation, nurse and provider productivity and continuity of care.
- Develop a conceptual framework for quality measurement and improvement activities across clinic sites. Summarize findings in the annual Quality Improvement (QI) Plan.
- Work with Nurse Navigation leadership to develop and ensure the implementation of policies to minimize risk within the organization.
- Work with the Medical Director and Director of Nursing to develop new or update existing clinical outcome measures, protocols, policies, and procedures to ensure compliance with policies through a peer review process.
- Manage and oversee Quality Assurance Coordinator(s).
- Develop nurse patient interaction audit systems, perform data analysis, and prepare reports related to measuring clinical performance.
- Serve as the Nurse Navigation liaison to our client’s management team. Coordinate and lead regular meetings with the client to ensure issue identification and proactive problem solving.
- Provide support to Account Managers to analyze client’s markets and develop plans which match the supply of healthcare services appropriately to meet client demands.
- Coordinate the resolution of service delivery challenges.
- Respond to, document, and ensure follow up to all service inquiries received from internal and external customers in a timely and thorough manner.
- Maintain a thorough understanding of all existing contract provisions.
- Participate in the assessment and development of Process Improvement Plans, Workflows, Project Plans, Implementations, as required.
- Assist in regularly scheduled internal and external Quality Committee meetings that are conducted locally or onsite at the customer location (travel) or virtually, as appropriate.
- Provide support to stakeholders in developing, distributing and presenting reports as needed, i.e., dashboards, performance reports, proposals in a timely manner as required by client or contract.
- Support the integration of client new or expanding markets assuring a well-coordinated delivery of service.
- Ensure compliance with policies and procedures and ensure continuous quality improvement.
- Demonstrate that internal customers are as valuable as external customers, project appreciation and respect for all team members.
- Support and foster a culture of honesty and integrity that fully conforms to the company’s quality and compliance programs.
- Actively develop, train, and promote the use of work teams for process improvement; share information with others to increase the use of best practices.
- Implement changes to integrate operational initiatives associated with organizational strategy.
- Work in tandem with Medical Director to measure, evaluate and adjust clinical protocols for ongoing quality improvement.
- Participate in call taking as needed.
- Participate in interviewing and hiring new staff members as needed.
- Adhere to all company policies and procedures.
- Perform other duties as assigned.
QUALIFICATIONS
Knowledge, Skills, and Abilities:
- Understanding of clinical quality guidelines, compliance, and policy development.
- Ability to work collaboratively.
- Ability to communicate effectively with Senior Management Team, Providers, and all staff.
- Ability to work in highly complex, technical environments.
- Outstanding communication and interpersonal skills.
- Excellent organizational and leadership skills with problem-solving ability.
- Excellent communication and presentation skills (written, verbal)
- Ability to measure and evaluate client needs, as it relates to operational and clinical practice.
- Strong interpersonal, organizational, leadership, and prioritization skills.
- Being self-motivated.
- Maintaining a flexible schedule to accommodate clinical hours for coaching.
- Strong skills in using Microsoft tools as such as, Outlook, Teams, PowerPoint, Smartsheet.
Education/Licensing/Certification:
- Active RN license in good standing with the ability to obtain compact and non-compact state licensures.
- BSN/Masters preferred.
- A minimum of three year’s related work experience in quality management, risk management or equivalent combination of education and experience is preferred.
Why Choose GMR? Global Medical Response’s (GMR) family of solutions. Our GMR teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services. View the stories on how our employees provide care to the world at www.AtaMomentsNotice.com. Learn how our values are at the core of our services and vital to how we approach care and check out our comprehensive benefit options at GlobalMedicalResponse.com.
EEO StatementGlobal Medical Response and its family of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.
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