Quality Management Nurse - Value Based Programs*

San Bernardino County; Colton (CA); Presencial; USD 90.000 - 130.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Excellent benefits

Modified Benefits Option (MBO)

Descripción de la vacante

Arrowhead Regional Medical Center (ARMC) in Colton, CA is hiring a Quality Management Nurse for Value Based Programs. The role combines clinical expertise, data analysis, and quality improvement to review PLD files, audit charting, and identify coding gaps across outpatient and inpatient care.

The position supports VBPs, including QIP and P4P metrics, with collaboration across clinical and administrative teams and education for staff on quality metrics.

Formación

• Must hold California RN license and CPR/BLS.
• Minimum 1 year RN direct care; or 2 years with QA/quality improvement experience.
• Experience with quality metrics review and chart audits preferred.

Responsabilidades

• Review PLD files for QIP metrics and related quality data.
• Audit charting and documentation for outpatient and inpatient services.
• Identify charting and coding gaps needing remediation.
• Analyze quality metrics and provide clinical insight.
• Collaborate with teams to support documentation quality.
• Coordinate provider and staff education on quality metrics.

Conocimientos

Clinical assessment

Data analysis

Quality improvement

Communication

Educación

RN license (CA)

BLS/CPR certification

Herramientas

Electronic Health Records (EHR)

Quality metrics dashboards

Descripción del empleo

Arrowhead Regional Medical Center (ARMC) is hiring for Quality Management Nurse - Value Based Programs who perform ongoing review of patient level detail (PLD) files for Quality Incentive Pool (QIP) metrics, audit charting, and documentation associated with outpatient services and inpatient stays; identify charting and coding gaps or errors which require remediation. This role offers a unique opportunity to combine clinical expertise, data analysis, and quality improvement within a dynamic public healthcare environment.

*Official Job Title: Quality Management Nurse. For more detailed information, refer to the job description.

Duties may include, but are not limited to, the following:

• Perform ongoing review of patient-level detail (PLD) files related to Quality Incentive Pool (QIP) metrics.
• Conduct chart audits and review clinical documentation associated with outpatient services and inpatient stays.
• Identify charting and coding gaps or errors requiring remediation.
• Analyze quality metric performance and provide meaningful clinical insight based on assigned programs.
• Collaborate with clinical and administrative teams to support accurate documentation and quality improvement efforts.
• Coordinate education and training for providers and clinical staff related to quality metrics.
• Participate in clinical process improvement efforts related to Value-Based Programs (VBP) metrics.
• Contribute to a holistic understanding of ARMC’s quality performance and compliance with regulatory requirements.
• Analyze performance for all active value-based programs, including, but not limited to, the Quality Incentive Pool (QIP) and IEHP Pay for Performance (P4P) programs, including HEDIS measures.

VALUE BASED PROGRAMS

Value Based Programs (VBPs) reward public healthcare systems when high quality care is provided to patients. This is measured by several comprehensive quality metrics, audited by the Department of Health Care Services (DHCS) and contracted Health Plans. At ARMC, VBPs are designed to drive continuous improvement in quality of care through comprehensive data analytics and clinical review. Incumbents assigned to VBPs are responsible for identifying, quantifying, and providing holistic analysis on ARMC's quality metrics, dependent upon assignment.

ARROWHEAD REGIONAL MEDICAL CENTER

Located on a beautiful 70-acre campus in Colton, California (50 miles east of Los Angeles), Arrowhead Regional Medical Center (ARMC) is a state-of-the-art, public/nonprofit, 456-bed, university affiliated teaching hospital licensed by the State of California Department of Public Health and accredited by The Joint Commission. The hospital houses a regional burn center serving four counties (San Bernardino, Riverside, Mono and Inyo), a comprehensive stroke center, level I trauma center and a freestanding in-patient behavioral health center. Additionally, ARMC operates five community-based, primary care clinics and over 40 specialty care outpatient services. ARMC is the primary teaching hospital for the adjacently located California University of Science and Medicine (CUSM), the Inland Empire's newest medical school. To find out more about Arrowhead Regional Medical Center, please visit: www.arrowheadregional.org

EXCELLENT BENEFIT

To review job- specific benefits, refer to: Summary of Benefits Nurses Unit and the Memoranda of Understanding (MOU). The County also offers an alternative Modified Benefits Option (MBO) that provides a wage differential.

CONDITIONS OF EMPLOYMENT

Pre-Employment Process: Incumbents must pass a background investigation, which includes fingerprinting, work history and education verification, as well as a job-related physical exam and drug screening.

Training: Training will be provided online and administered at an ARMC and/or a County training facility.

Travel: Travel throughout the County may be required. Employees will be required to make provisions for transportation. Mileage reimbursement may be available.

Sponsorship: Please note San Bernardino County is not able to consider candidates who will require visa sponsorship at the time of application or in the future.

Candidates must possess ALL of the following:

LICENSE

Must possess and maintain licensure as a Registered Nurse with the State of California Board of Registered Nursing.

CERTIFICATION

Healthcare Provider level Basic Life Support certification issued by the American Heart Association.

EXPERIENCE

• OPTION 1: One (1) year of full-time equivalent experience in direct patient care as a Registered Nurse in an acute care hospital, primary care clinic, or Medicaid plan.
• OPTION 2: Two (2) years of full-time equivalent experience as a Registered Nurse in an acute care hospital, primary care clinic, or Medicaid plan with experience in performance improvement, quality management and/or patient safety, case management, utilization review/utilization management, or care coordination.

The ideal candidate will possess experience reviewing quality metrics for a Designated Public Hospital (DPH), primary care clinic, or Medicaid plan, or experience in case management, utilization review, or clinical documentation review involving chart audits, coding validation, or medical record abstraction.

Examination Procedure

Please complete and submit the online employment application and supplemental questionnaire by 5:00 pm, Friday, October 23, 2026. Resumes will not be accepted in lieu of the application and/or supplemental questionnaires. Do not refer to a resume as it will not be reviewed.

Equal Employment Opportunity (EEO) / Americans with Disabilities Act (ADA): San Bernardino County is an Equal Employment Opportunity (EEO) and Americans with Disabilities Act (ADA) compliant employer, dedicated to ensuring equal employment opportunities for allemployees and applicants.

ADA Accommodation

If you have a disability and need accommodations during the testing process, please submit the Special Testing Accommodations Request Form within one week of the recruitmentfiling deadline.

Veterans’ Preference: Eligible veterans and their spouses or widows/widowers who are not current County employees may receive additional Veterans' Preference points. For details and instructions on how to request these points, please refer to the Veterans' Preference Policy.

For more important details, review the Applicant Information and County Employment Process.