Senior Quality Assurance Manager Nurse

1199-Seiu; New York (NY); On-site; USD 110,000 - 170,000; Full time

Job summary

1199-SEIU is seeking a Nursing Quality Improvement Director to lead registered nurses and allied clinical staff. You will oversee daily operations, drive quality initiatives, monitor metrics, and collaborate with providers to enhance care across chronic conditions.

The role requires NYS RN licensure, a Bachelor's degree, and extensive ambulatory/community health experience with proven leadership in quality assurance and improvement efforts. Flexibility for varied hours in NYC region.

Qualifications

• Valid New York State RN license is required.
• Bachelor's degree required.
• 6+ years nursing experience in ambulatory care, community health care, or medical/surgical settings, incl. 3+ years in quality improvement and 4+ years in management.
• Strong clinical assessment, patient education, motivational interviewing, critical thinking, and independent decision-making.
• Excellent nurse-physician communication, leadership, coaching, and team-building skills.
• Knowledge of HEDIS and NCQA.
• Proficient with Microsoft Outlook, Word, and Excel.

Responsibilities

• Provide strategic and operational leadership to registered nurses and allied clinical staff.
• Oversee daily operations, ensuring efficient workflows and appropriate staffing levels.
• Participate in coordinating and developing Quality Improvement initiatives and monitor performance metrics and outcomes.
• Review population-based data to identify trends, gaps, and opportunities for quality improvement across chronic conditions for provider groups and individual providers.
• Serve as a clinical liaison between the Fund and Providers on quality-of-care concerns (HEDIS and other Performance Measures).
• Review performance, evaluate effectiveness, analyze data, identify trends, and collaborate with business leads to recommend enhancements.
• Engage Fund RN, Health Educators, and Social Workers in quality assurance projects.
• Assist Medical Director in hiring, recruiting, onboarding and evaluation of clinical staff.
• Provide supervision, mentoring, coaching, and clinical oversight of Wellness staff.
• Educate members regarding acute and chronic conditions and promote healthier lifestyle behaviors.
• Participate in seasonal vaccination and other testing as needed.
• Participate in Health Fairs, Screenings, and Outreach Events in NYC and outer boroughs.
• Perform additional duties and projects as assigned by management.
• Ability to work flexible hours including evenings and weekends as needed.

Skills

Clinical assessment

Patient education

Motivational interviewing

Critical thinking

Independent decision-making

Quality assurance

Quality improvement

Nurse-physician communication

Leadership

Team-building

Education

Bachelor's degree

Tools

Microsoft Outlook

Microsoft Word

Excel

Job description

Responsibilities

• Provide strategic and operational leadership to registered nurses and allied clinical staff
• Oversee daily operations, ensuring efficient workflows and appropriate staffing levels
• Participate in coordinating and developing Quality Improvement initiatives and monitor performance metrics and outcomes
• Review generic charts and other population-based data to identify trends, gaps, and opportunities for quality improvement across chronic conditions for provider groups and individual providers, then address them
• Serve as a clinical liaison between the Fund and Providers on quality-of-care concerns (HEDIS and other Performance Measures)
• Review performance, evaluate effectiveness, analyze data, identify trends, and collaborate with business leads to recommend enhancements
• Engage Fund Registered Nurses (RN), Health Educators (HE), and Social Workers (SW) in quality assurance projects, such as outreach to members with gaps in care
• Assist Medical Director in hiring, recruiting, onboarding and evaluation of clinical staff
• Provide supervision, mentoring, coaching, and clinical oversight of all Wellness clinical staff to strengthen competencies.
• Educate members regarding acute and chronic conditions and promote healthier lifestyle behaviors.
• Participate in seasonal vaccination and other types of testing as needed.
• Participate in Health Fairs, Screenings, and Outreach Events in New York City and outer borough locations as needed
• Perform additional duties and projects, as assigned by management
• Ability to work flexible hours including evenings and weekends as needed

Qualifications

• A valid New York State Registered Nurse (RN) license is required; Bachelor’s degree required
• Minimum of six (6) years of nursing experience in ambulatory care, community health care, or medical/surgical settings, including at least three (3) years in quality improvement and four (4) years in management required
• Strong experience in clinical assessment, patient education, motivational interviewing, critical thinking, independent decision-making, quality assurance, and quality improvement
• Excellent nurse-physician communication, leadership, coaching, and team-building skills are required.
• Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA)
• Intermediate computer and digital literacy
• Basic proficiency in Microsoft Outlook, Word, and Excel is preferred