RN Clinical Policy Manager

0090 Presbyterian System Services; United States; On-site; USD 66,000 - 112,000; Full time

Benefits offered by this job

Tuition reimbursement

Scholarship opportunities

Staff safety badge

Night/weekend shift differentials

Malpractice insurance

Loan forgiveness (NM)

EPIC electronic charting system

Job summary

Presbyterian Healthcare Services seeks an experienced policy leader to manage intake, scoping, and development of clinical policies across our health system. You will ensure regulatory compliance, evidence-informed practice, and patient safety while guiding multi-stakeholder reviews and implementation.

The role emphasizes governance, documentation control, and collaboration with operational leaders to train staff and align policies with CMS, Joint Commission, HIPAA, and state requirements.

Qualifications

• Licensed RN in New Mexico (NM)
• Bachelor’s in nursing; Master’s preferred
• Minimum 5 years healthcare experience
• Evidence of participation/leadership in policy development or revision, quality, or risk management

Responsibilities

• Lead clinical policy development and governance.
• Cross-check policies to avoid duplication.
• Ensure CMS, Joint Commission, OSHA, HIPAA compliance.
• Support accreditation readiness and survey activities.
• Develop regulatory plans for corrective actions.
• Participate in rapid compliance improvement activities.
• Review clinical events to identify policy improvements.
• Oversee policy review cycles and document control.
• Collaborate with leaders on policy implementation and training.
• Participate in committees and work groups.

Skills

Policy development

Regulatory compliance

CMS/Joint Commission/ HIPAA

Evidence-based practice

Stakeholder collaboration

Leadership & governance

Education

Bachelor's degree in nursing

Master's degree preferred

Tools

EPIC

Job description

Location Address: 9521 San Mateo NE Albuquerque, NM 87113-2237

Compensation Pay Range: Minimum Offer $65,520.00 Maximum Offer $111,612.80

Summary: Responsible for intake and scoping of incoming draft clinical policies, for development of new policy, revision of current policy, multi-stakeholder review for compliance with standard work, publication, implementation across the health system ensuring regulatory compliance, evidence-based/evidence-informed practice, patient safety and quality assurance.

How you grow, learn and thrive matters here.

• Educational and career development options, including tuition and certification reimbursement, scholarship opportunities


• Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)


• Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)


• Malpractice liability insurance


• Loan forgiveness through the New Mexico Higher Education Department


• EPIC electronic charting system

Type of Opportunity: Full time FTE: 1.00 Job Exempt: Yes Work Shift: Days (United States of America)

Responsibilities

• Lead clinical policy development and governance


• Cross check for associated policies, guidelines, or protocols within the system to eliminate duplication or multiple policies with similar requirements


• Ensure compliance with CMS, Joint Commission, OSHA, HIPAA, state regulations and Licensing and Credentialing organizations, Professional Organization guidelines.


• Participates and Supports accreditation readiness and survey activities including responding to actual surveys serving as a clinical policy resource.


• Participates in the development and implementation of regulatory Plans for Correction to ensure compliance with standards and risk mitigation.


• Participates, serves as resource in Rapid Compliance Improvement activities including conducting audits for policy compliance.


• Participates/provides resource for review of clinical events and incidents to identify areas of opportunity with current policies, procedures or guidelines.


• Serves as Subject Matter Expert regarding policy and protocol development to include verifying resources e.g., literature review for evidence-based practice and collaborating with system resources for evidence-informed practice. This may include facilitation of groups or teams in policy/protocol development as well as presentation of research and literature reviews and comparison for optimal policy development.


• Oversees clinical policy review and approval cycles, ensuring effective document control, retention, and archival of records as required.


• Partners with operational leaders on the implementation of clinical policies and procedures to include clinical education collaboration for ensuring training is accurate per the established policy, procedure or guideline.


• Participate in committees, work groups as appointed or deemed necessary.

Qualifications

• Licensed as a Registered Nurse in the State of New Mexico


• Bachelor’s degree in nursing, master’s degree preferred.


• Minimum 5-years healthcare experience.


• Evidence of participation/leadership in policy or protocol development such as facilitation of improvement initiatives requiring policy or protocol implementation or revisions, quality, compliance, accreditation, or risk management activities, and performance improvement

Key Competencies

Proficient knowledge of clinical healthcare operations, regulatory requirements, and clinical practice standards, Policy writing and development, review of the literature for evidence based practices, regulatory interpretation, proficient organizational skills, stakeholder collaboration and engagement, attention to detail, strong communication and presentation abilities, with the capacity to engage stakeholders and influence outcomes.

We're all about well-being, starting with yours.

Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more. Learn more about our employee benefits.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are 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 1600 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.

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.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services Here, we’re committed to a different way to make a difference.

Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, nurses, employees, board members, and volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than one in three New Mexicans. We are part of New Mexico's history and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

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