Remote RN Quality Management Specialist – Work From Home

The RN Quality Management Specialist (QMS), will work from your home office from Monday to Friday, 8AM – 5PM Eastern Time and be part of a collegial team that is responsible for supporting the Quality Management System (QMS) for a high-profile client. This role involves both clinical and non-clinical tasks to ensure compliance with QMS and client contracts. The QMS identifies requirements and creates processes to ensure consistent and reliable execution of work. They coordinate the creation of controlled documents such as Standard Operating Procedures and Work Instructions, perform audits to meet performance metrics, and address internal and client concerns. Additionally, the QMS tracks and mitigates risks, facilitates continual improvement by leading improvement projects, and supports contract managers and the analytics team in preparing quality assurance reports.

*RN required/Vocational Rehabilitation Case Management/Workers Comp

*Experience with quality deliverables in accordance with PWS

*Must be a US Citizen to be considered

Duties and Responsibilities:

· Provides input to managers and teams regarding analysis, updates, and recommendations for modifications for procedures and processes to continually improve operations and protocols.

· Assist with collection and summary of data in collaboration with Quality Committees, identifies opportunities for improvement, and presents findings.

· Understands each contract’s clinical quality assurance requirements and monitors compliance, in collaboration with the analytics and management teams.

· Monitors and analyzes clinical outcomes in relation to goals and contractual requirements, in collaboration with the analytics and management team.

· Performs standard and ad hoc audits of case management activities, as directed by quality committees.

· Provides feedback and coordination for improvement of quality tools, such as audit checklists and instructions.

· Assists in the identification of program deficits and coordinates team training and monitoring of corrective actions.

· Assists with performance improvement activities.

· Tracks client complaints and issues to resolution, in collaboration with the Account Managers.

· Identifies new areas that need quality monitoring, on a short-term or continuous basis.

· Assists in activities to prioritize improvement initiatives.

· Investigates and incorporates national best-practice interventions into processes in conjunction with clinical management.

· Ensures that documentation produced and/or processed complies with federal regulations and contractual requirements.

· Assumes responsibility for related duties as required or assigned.

Qualifications

· Registered Nurse (RN), licensed in any state, with national certification in a relevant field

· Minimum of 1-3 years’ experience with quality improvement, corrective action, auditing, and/or staff education

· Bachelor’s Degree highly preferred in Healthcare, Nursing, Health Administration, or a related field; Master’s Degree a plus.

· Familiarity with government contracting and requirements preferred.

· Demonstrated ability to ensure quality deliverables in accordance with the PWS, and to ensure that all required performance standards are met

· Experience with nursing and/or vocational rehabilitation case management in the FECA or other workers compensation arena preferred. Utilization review.

· A proven track record in meeting deliverable schedules and performance requirements for programs of a similar size and scope is required.

· Attention to detail, timetables, and commitment to completing tasks

· Proficiency in computer use, including Microsoft Office Word, PowerPoint, Excel, and Outlook, strong analytical skills in interpreting data, and the ability to multi-task effectively.

· Well organized, efficient, and able to work independently and within a team

· Reliable High-Speed Cable or Fiber Optic Internet service and Internet Router in established home office

· Excellent Communication Skills via Phone, E-Mail, Text, Verbal, Documentation Skills, ability to create and complete comprehensive, accurate, and constructive written reports

· Ability to pass a preliminary credit and background check

· Ability to obtain and maintain public trust federal security clearance(s)

· Ability to travel if necessary

A comprehensive benefits package is offered including, but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Successful candidates will be required to undergo a financial and criminal background check and obtain and maintain confidential-level security clearance upon hire.

Equal Opportunity and Affirmative Action Employer

All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, disability, marital status, national origin, race, religion, sex, sexual orientation, gender identity, veteran status, or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the person’s relatives, friends or associates.

Job Type: Full-time

Pay: $65,000.00 – $75,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Medical Specialty:

• Cardiology
• Critical & Intensive Care
• Dietetics
• Geriatrics
• Home Health
• Hospice & Palliative Medicine
• Hospital Medicine
• Infectious Disease
• Medical-Surgical
• Neurology
• Pain Medicine
• Perioperative Care
• Physical & Rehabilitation Medicine
• Psychiatry
• Public Health
• Urology
• Wound Care

Education:

• Bachelor’s (Preferred)

Experience:

• Quality improvement: 1 year (Preferred)
• Quality audits: 1 year (Preferred)
• Corrective Action: 1 year (Preferred)
• Staff Education: 1 year (Preferred)
• Nursing: 1 year (Preferred)
• Workers’ compensation: 1 year (Preferred)
• Government Contracting: 1 year (Preferred)

License/Certification:

• RN License (Required)

Work Location: Remote