Quality Critical Incident Clinical Coordinator

Presbyterian Healthcare Services; Albuquerque (NM); Remote; USD 60,000 - 80,000; Full time

Job summary

Join a forward-thinking healthcare organization as a Quality Critical Incident Clinical Coordinator. This role involves overseeing the Critical Incident Reporting process, ensuring that members' healthcare needs are met while adhering to contractual obligations. You will apply your clinical judgment to assess incidents, collaborate with various teams, and contribute to quality improvement initiatives. This dynamic position offers a chance to make a significant impact on patient care and safety in a supportive environment. If you are a dedicated RN with a passion for quality improvement and teamwork, this opportunity is perfect for you.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Paid Time Off

Retirement Plan

Employee Wellness Program

Qualifications

• Current New Mexico RN License required.
• 3-5 years of clinical nursing experience with quality improvement preferred.

Responsibilities

• Coordinate Critical Incident Reports and ensure timely processing.
• Collaborate with various teams for follow-up activities.

Skills

Clinical Judgment

Written Communication

Oral Communication

Facilitation Skills

Nursing Judgment

Education

Associate's Degree

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Overview

Now hiring a Quality Critical Incident Clinical Coordinator.

Critical Incident Reporting is a contractual requirement within the State of New Mexico and Presbyterian Health Plan Medicaid Contract. Critical Incidents include but are not limited to reports of abuse, neglect, and exploitation towards a Member. This Registered Nurse position is responsible for the coordination of a variety of aspects of the Critical Incident Reporting process, initiatives, and specialized program activities with minimal oversight and independent judgment. Responsible for processing daily assignments of Critical Incidents timely and accurately to ensure Members' healthcare and safety needs are met and contractual timelines are adhered to.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

• Full Time - Exempt: Yes
• Job is based at Rev Hugh Cooper Admin Center
• Remote work from home: this job is intended to be conducted in the state of New Mexico.
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement, and more for FT employees.

Ideal Candidate:

• Associate's Degree.
• Current New Mexico RN License.
• Three to five years of experience in the clinical nursing field required, with three years of quality improvement experience preferred.
• Demonstrated ability to apply nursing judgment to complex member situations. Knowledge of case management and care coordination concepts and activities preferred.
• Excellent written, oral, and facilitation skills required.
• Proficiency in Microsoft Word, Excel, and Outlook required. Demonstrates ability to work with highly sensitive and confidential information.

Responsibilities

• Under the supervision of the Critical Incident Management RN Supervisor, this position is responsible for applying clinical judgment to Critical Incident Reports.
• Completes daily processing of incoming Critical Incidents on the NM CIR Portal and refers all Critical Incidents for appropriate follow-up activities with Care Coordination, Providers, Adult Protective Services, Children Youth and Families Department, and/or other quality workflows as needed.
• Documents all pertinent Critical Incident data and information in the PHP internal database.
• Upon gaining knowledge and expertise, will process more complex Critical Incidents.
• Collaborates with the Quality of Clinical Care (QOCC) Team to identify and refer appropriate referrals from CIR for QOC investigation.
• Actively participates and collaborates with the CIR team in routine team and department meetings to identify issues, trends, best practices, and process improvement activities.
• Performs other duties as assigned.

Benefits

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance, and other optional voluntary benefits.

Wellness: Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinars, preventive screenings, and more.

Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services: Presbyterian exists to improve the health of patients, members, and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan, and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care), and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke-free campuses.

Maximum Offer for this position is up to

USD $41.39/Hr.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.