Quality & Care Management Leader

Covenant Health; Oregon (WI); On-site; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare provider in the United States is looking for a Manager, Quality and Care Management. The role involves promoting performance improvement and regulatory compliance, as well as managing care functions to ensure patients have an optimal experience. Ideal candidates should hold a relevant bachelor's degree, have at least five years of experience, and a valid Tennessee RN license. This position offers the chance to lead initiatives that directly impact patient care quality and safety.

Qualifications

• Minimum of five (5) years of experience with three (3) years in a hospital setting.
• Valid Tennessee RN license required if degree is in Nursing.
• CCM, ACM, or CPHQ certification preferred.

Responsibilities

• Develops department budgets reflecting effective management.
• Collaborates with leaders for strategic initiatives.
• Ensures compliance with regulatory standards.
• Manages Care Management functions for patient coordination.

Skills

Management of care

Budget management

Performance improvement

Quality improvement principles

Interdisciplinary collaboration

Education

Bachelor’s degree in Nursing, Social Work, Healthcare Administration, or related field

Job description

Overview

Manager, Quality and Care Management, Quality Management

Full Time, 80 Hours per pay period, Day Shift

Parkwest Overview

Parkwest Medical Center , Covenant Health’s flagship facility in West Knoxville, combines world-class cardiac expertise with the warmth of home in serving a vibrant East Tennessee community. Since 1973, Parkwest has grown into the region’s largest hospital in the area, offering advanced services like an all-digital catheterization lab, comprehensive breast health, emergency, and critical care. It’s consistently ranked among Tennessee's top 10 hospitals by U.S.News & World Report and earns national recognition as a Top100 Heart Hospital, as well as an “A” safety grade from Leapfrog. As part of Covenant Health, the region’s largest employer, Parkwest Medical Center, marries cutting-edge technology with compassionate, community-centered care, earning accolades for cardiology, stroke, surgical excellence, and patient safety.

Overview

Manager, Quality and Care Management, Quality Management

Full Time, 80 Hours per pay period, Day Shift

Parkwest Overview

Parkwest Medical Center , Covenant Health’s flagship facility in West Knoxville, combines world-class cardiac expertise with the warmth of home in serving a vibrant East Tennessee community. Since 1973, Parkwest has grown into the region’s largest hospital in the area, offering advanced services like an all-digital catheterization lab, comprehensive breast health, emergency, and critical care. It’s consistently ranked among Tennessee's top 10 hospitals by U.S.News & World Report and earns national recognition as a Top100 Heart Hospital, as well as an “A” safety grade from Leapfrog. As part of Covenant Health, the region’s largest employer, Parkwest Medical Center, marries cutting-edge technology with compassionate, community-centered care, earning accolades for cardiology, stroke, surgical excellence, and patient safety.

To learn more about Parkwest Medical Center and our units, visit Covenant Health Parkwest Medical Center Opportunities .

Position Summary

Responsible for the planning, organization, management, and evaluation of operations of quality, care management, infection prevention, performance improvement, regulatory compliance, and medical staff services of assigned facilities. Responsible for the coordination of care and outcomes of clinical and operational metrics for all patients through the continuum of care. Knowledgeable in quality improvement principles, regulatory, and Care Management standards. The manager is responsible for budget management, staffing, hiring, discipline, and performance management for applicable departments. The Quality Manager/Care Manager is responsible for collaborating with appropriate enterprise leaders when applicable.

When the Quality Manager does not have oversight of Care Management, those applicable accountabilities and performance criteria are non-applicable.

Responsibilities

• Develops department budgets that reflect effective management of resources to provide services.
• In collaboration with enterprise leadership, facility leadership, and medical staff, assists in the development of strategic initiatives for the department and facility.
• Collaborates with interdisciplinary groups and leaders to identify and monitor key processes and patient outcomes. Uses various data sources, including but not limited to, publicly reported data to inform which processes and outcomes to monitor. Facilitates effective communication of results to medical staff and other key stakeholders.
• Identifies opportunities for improvement using Covenant performance improvement methodologies to implement corrective action plans and evaluate results for desired outcomes.
• Manages Care Management functions to ensure the coordination of care for patients so they move seamlessly through the continuum of care.
• Stays abreast of regulatory, licensing, and certification (Joint Commission, CMS, Leapfrog, State, etc.) standards to ensure processes are in place to achieve desired outcomes.
• Collaborates with the Peer Review/PQPR medical staff chair to operationalize assessments of peer review triggers and functions of the facility medical staff.
• Collaborates with clinical and medical staff to implement processes, as needed, to ensure financial and length of stay metrics are assessed and communicated to applicable medical staff and organizational leaders.
• Operationalizes a Care Management Model to ensure timely and effective throughput through the continuum of care. Serves as a coach, mentor, and role model for all team members.
• Oversees activities of medical staff credentialing, FPPE/OPPE, and departmental organization including, but not limited to, facilitating applicable medical committee meetings to ensure effective patient safety and regulatory compliance.
• Collaborates with enterprise infection prevention management and local leaders to assess and support the infection prevention strategies as needed.
• Oversees survey action plans and ongoing assessments of regulatory readiness for all accreditation, certification, and state surveys.
• Collaborates with nursing, medical staff, and other disciplines to assess and improve outcomes related to performance with various measures associated with publicly reported entities.
• Proactively seeks opportunities to reduce waste and redundancy in the utilization of resources.
• At a minimum participates in the Quality, Peer Review, Regulatory, Infection Prevention, and Credentials Committees. The Quality Manager may serve as the committee facilitator as needed.
• Communicates with medical staff to improve utilization of resources and compliance with evidenced based care as deemed necessary.
• Collaborates with medical staff and facility leadership to determine the frequency, quality, and monitoring of multidisciplinary rounds.
• Provides data to stakeholders on an ongoing basis to inform stakeholders on progress towards applicable enterprise and business unit clinical and operational goals.
• Local travel required.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.
  
  

Qualifications

Minimum Education:

Bachelor’s degree or higher in Nursing, Social Work, Healthcare Administration, Public Health, or other related field.

Minimum Experience

A minimum of five (5) years of experience with at least three (3) years in a hospital setting.

Licensure Requirement

Must have and maintain a valid Tennessee RN license if degree is in Nursing. CCM, ACM, or CPHQ certification preferred. Employee must have a valid Tennessee driver’s license and state mandated minimum insurance coverage. Driving record must meet Covenant Health minimum standards at the date of hire and throughout employment tenure.