Senior Clinical Quality Improvement Specialist

VNS Health; New York (NY); Hybrid; USD 93.000 - 117.000; Vollzeit

Benefits dieser Stelle

Referral bonus opportunities

30 days PTO + 9 holidays

Health insurance for you and family

Employer-matched retirement savings

Wellness programs

Pre-tax FSAs

Tuition reimbursement

Professional growth opportunities

Internal mobility and advancement

Zusammenfassung

VNS Health in New York seeks a Quality Improvement Nurse Leader to drive QI initiatives across DOH, CMS, and NCQA standards. You will conduct clinical reviews, support care coordination, and coach teams in PDSA, LEAN, and data-driven improvement with cross-functional partners.

The role emphasizes performance measurement (HEDIS/CAHPS), alignment with regulators, and development of training to sustain quality and regulatory readiness.

Qualifikationen

• Licensed Registered Nurse in NY or NJ (current registration).
• Bachelor's Degree in Nursing, Social Work or related Behavioral Health field.
• Minimum 5 years of health plan or health care experience.
• Minimum 4 years of quality improvement experience.
• Minimum 2 years in quality management and compliance.
• Experience leading cross-functional quality initiatives.
• Excellent oral and written communication; group facilitation skills.
• Knowledge of PDSA/LEAN; Six Sigma preferred; data analysis experience.

Aufgaben

• Conduct clinical assessments including medication reconciliation and post-discharge follow-up.
• Collaborate across departments to ensure DOH/CMS/NCQA compliance and coach teams in continuous improvement.
• Perform medical record audits and support HEDIS/QARR documentation.
• Lead multidisciplinary QI teams to design, implement, and evaluate improvement initiatives.
• Support value-based programs through data review and provider feedback.
• Develop training materials, guidelines, and quality protocols for provider networks.

Kenntnisse

Quality improvement

Cross-functional collaboration

Communication

Data analysis

Ausbildung

Bachelor's Degree Nursing or related Behavioral Health field

Tools

PDSA

LEAN

Six Sigma

Jobbeschreibung

VNS Health in New York seeks a Quality Improvement Nurse Leader to drive QI initiatives across DOH, CMS, and NCQA standards. You will conduct clinical reviews, support care coordination, and coach teams in PDSA, LEAN, and data-driven improvement with cross-functional partners.

The role emphasizes performance measurement (HEDIS/CAHPS), alignment with regulators, and development of training to sustain quality and regulatory readiness.