Clinical Nurse Quality Manager

DataStaff, Inc.; Raleigh (NC); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Competitive benefits package

401K program after 6 months

Paid vacation, sick and holiday leave

Job summary

DataStaff, Inc. is seeking a Clinical Nurse Quality Manager for a long-term contract in Raleigh, NC. The role is hybrid with 2x per week on-site.

The incumbent will develop, implement, and monitor quality improvement initiatives to improve Medicaid outcomes. The position requires strong leadership, advanced analytics, and extensive nursing experience. Key duties include coordinating QI activities, analyzing data from health plans, and advising leadership on KPIs and policy development to drive

Qualifications

• 2-3 years of Quality Improvement experience.
• Experience with HEDIS measures.
• Nursing experience preferred (5+ years).
• CPHQ or PMP or Six Sigma Yellow Belt certifications give advanced credit.
• Preferred experience with managed care, Medicaid, Medicare, or Accountable Care Organizations.
• Population health interventions knowledge is a plus.

Responsibilities

• Coordinate with key stakeholder teams inside and outside of DHB for enhancement of QI activities.
• Identify opportunities for improvement based on analysis of data from Health Plans, the State, and other data sources.
• Provide feedback to leadership on initiatives, KPIs, or cross-collaborative opportunities for strategic planning.
• Provide Clinical Quality Expertise on Policy Development of Quality Improvement Activities.
• Manage relationships with healthcare stakeholders, offering evidence-based recommendations and ongoing feedback.
• Collaborate with other Business Units to enhance interoperability of Medicaid Quality activities.
• Support leadership in developing person-centered, wholistic performance improvement policies.
• Communicate with Health Plans to enhance member experience and outcomes.
• Stay updated on quality improvement trends and CMS/HEDIS/NCQA guidelines.
• Lead 2-3 Quality Improvement activities per 12-month contract.
• Support other QPHE projects as needed.

Skills

Leadership

Advanced analytics

Stakeholder engagement

Communication skills

Data interpretation

Education

ADN RN: 5 years experience

BSN: 3-5 years experience

MSN: 2-3 years experience

CPHQ or PMP or Six Sigma Yellow Belt

Tools

Microsoft Office Suite

Excel

PowerPoint

Word

Data analysis software

Job description

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.