Quality Improvement Nurse (RN) - Facility Site Review

Central California Alliance for Health; California; Hybrid; USD 91,000 - 146,000; Full time

Job summary

Join a leading health organization as a Quality Improvement Nurse (RN) focused on enhancing patient safety and healthcare quality. This role involves developing strategies in collaboration with stakeholders to improve health outcomes, participating in audits, and ensuring compliance with healthcare standards. Ideal candidates are detail-oriented registered nurses with a strong commitment to quality improvement.

Benefits

Medical, Dental and Vision Plans

Ample Paid Time Off

12 Paid Holidays per year

401(a) Retirement Plan

457 Deferred Compensation Plan

Robust Health and Wellness Program

Onsite EV Charging Stations

Qualifications

• Registered Nurse with a strong interest in quality improvement.
• Familiar with clinical protocols and documentation standards.
• Ability to evaluate medical records and support audits.

Responsibilities

• Develops and manages healthcare strategies in alignment with DHCS standards.
• Participates in audits to analyze and improve member health outcomes.
• Evaluates patient safety and communicates findings to stakeholders.

Skills

Detail-oriented

Organized

Clear communicator

Ability to manage time

Education

Associate’s degree in Nursing

Current, unrestricted license as a Registered Nurse

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Microsoft Outlook

Job description

Quality Improvement Nurse (RN) - Facility Site Review

Join to apply for the Quality Improvement Nurse (RN) - Facility Site Review role at Central California Alliance for Health

Quality Improvement Nurse (RN) - Facility Site Review

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Join to apply for the Quality Improvement Nurse (RN) - Facility Site Review role at Central California Alliance for Health

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We have an opportunity to join the Alliance as a Quality Improvement Nurse (RN) - Facility Site Review in the Quality Improvement and Population Health Department.

What You'll Be Responsible For

• Reporting to the Clinical Safety Supervisor - Facility Site Review (RN), this position: Develops, manages, and measures a comprehensive healthcare strategy in alignment with Department of Health Care Services (DHCS) standards of care and in collaboration with internal stakeholders and network providers to promote best evidence-based practices and improve member health outcomes
• Participates in local, regional, and state audits and initiatives to measure, analyze, and improve member health outcomes
• Evaluates patient safety and quality issues and communicates findings to internal stakeholders, network providers, and community partners
  
  

About The Team

Our goal is to ensure a safe and competent provider network by conducting three key types of site reviews for Primary Care Providers (PCPs): Physical Accessibility Reviews, Facility Site Reviews, and Medical Record Reviews. Through these reviews, we assess compliance with clinical, administrative, and environmental standards. We work collaboratively with providers to identify and resolve issues that impact the quality of care, supporting continuous improvement in clinical safety and service delivery.

THE IDEAL CANDIDATE

• Detail-oriented and organized registered nurse with a strong interest in quality improvement and patient safety
• Familiar with clinical protocols, documentation standards, and the importance of accurate medical record keeping
• Exposure to performance improvement concepts and an eagerness to learn how they align with healthcare regulations
• Clear communicator with the ability to collaborate effectively with both clinical and administrative staff
• Able to manage time well, stay professional in the field, and work independently with guidance
• Open to training and development opportunities, including certification programs required for advancement
  
  

What You'll Need To Be Successful

To read the full position description, and list of requirements click here.

• Knowledge of:
• Principles and practices of clinical nursing
• Medical practice operations and healthcare delivery systems
• Principles and practices of customer service
• Windows based PC systems and Microsoft Word, Excel, PowerPoint, and Outlook
• Methods and techniques of research, analysis, and reporting
• Ability to:
• Evaluate medical records and other health care data
• Participate in and support internal and external audits
• Interpret, apply, and explain policies, regulations, terms, and procedures
• Quickly learn and gain expertise in a broad variety of medical records systems
• Identify issues, conduct research, gather and analyze information and data, reach logical and sound conclusions, and make recommendations for action
• Education and Experience:
• Current, unrestricted license as a Registered Nurse issued by the State of California
• Possession and continued maintenance of Certified Site Reviewer certification as defined by DHCS within one year of hire
• Associate’s degree in Nursing and a minimum of five years of experience as a Registered Nurse in acute care or primary care with an emphasis in preventative care (a Bachelor’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying
  

Other Information

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.
  
  

The full compensation range for this position is listed by location below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Typical areas in Zone 1: Bay Area

Monterey County Pay Range

$91,056—$145,704 USD

Our Benefits

Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations
  
  

About Us

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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