Talent.com
Regulatory Quality RN Clinical Care-Intermediate
Regulatory Quality RN Clinical Care-IntermediatePresbyterian Healthcare Services • Albuquerque, New Mexico, United States
No longer accepting applications
Regulatory Quality RN Clinical Care-Intermediate

Regulatory Quality RN Clinical Care-Intermediate

Presbyterian Healthcare Services • Albuquerque, New Mexico, United States
6 days ago
Job type
  • Full-time
Job description

Overview

Presbyterian is seeking a Regulatory Quality RN Clinical Care-Intermediate

Responsible for PH Quality of Clinical Care (QOCC) activities. Investigates complaints alleging inappropriate Physical Health (PH) clinical care or alleged inappropriate behavior by a physician or other health care practitioner / provider. Applies the knowledge of a registered nurse to determine the key factors in each case and whether the standard of care has been met, documenting and summarizing findings for all parties regarding investigative findings. Collaborates on quality of clinical care work with PHP Business Partners including Medical Directors, Provider Network Operations, Credentialing, Care Coordination, Critical Incidents Team, and Legal counsel. Assists the provider peer review process which assesses and reviews the quality of patient and member care provided by practitioners and facilities.

  • This is a Full Time position - Exempt : Yes
  • Job is based at Rev Hugh Cooper Admin Center
  • Work hours : Days

Ideal Candidate : Bachelors in Nursing. Five years hospital nursing experience

Qualifications

  • Bachelors in Nursing
  • Five years hospital nursing experience
  • Current NM RN License
  • Skills in Outlook, Word, Excel, and Power Point
  • Proficiency in writing or professional correspondence
  • Preferred :

  • Critical Care experience
  • Complaint Management experience
  • Quality Improvement experience
  • Care Coordination / Case Management experience
  • Responsibilities

  • With guidance, reviews, responds to, and researches complaints related to quality of medical care utilizing a high level of knowledge and skill in nursing practice in order to discern the key factors in each case to ensure that all quality of care issues are identified and addressed.
  • Provides referrals, as appropriate to the case, to correlating PHP entities including but not limited to : Legal, Risk Management, Behavioral Health QOCC Team, Provider Network Operations, Credentialing, Critical Incidents Teams, or Care Coordination.
  • Perform Physical Health QOCC Case Management-all levels
  • Conduct Practice Pattern Reviews
  • Manage PIPs (Performance Improvement Plan)
  • Conducts Medical Record Review (MRR)
  • Prepare and Present Medical Director Reviews
  • Attend Weekly Medical Records Huddle
  • Writes QOCC Correspondence / Letters
  • With guidance, writes and presents QOCC case summaries to PHP's Physical Health Professional Practice Evaluation Committee (PH PPEC).
  • With guidance, manages and communicates PH PPEC recommendations including but not limited to : Practice Pattern Reviews, Performance Improvement Plans, and / or Recommendations for Terminations, Suspensions, or Admissions Holds.
  • Other duties as assigned.
  • Benefits

    About Presbyterian Healthcare Services

    Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.

    The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift to earn gift cards and other incentives.

    As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships. Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.

    AA / EOE / VET / DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

    Maximum Offer for this position is up to

    USD $42.63 / Hr.

    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.

    Create a job alert for this search

    Clinical Quality Rn • Albuquerque, New Mexico, United States

    Related jobs
    Registered Nurse (RN) - Excellent PRN rates : $47 / hour

    Registered Nurse (RN) - Excellent PRN rates : $47 / hour

    Encompass Health • Cedar Crest, NM, US
    Full-time +1
    Registered Nurse Career Opportunity.Now offering a $10,000 Sign on Bonus!.Respected and valued for your Registered Nurse skill set. Are you looking for a career thats close to your heart and close t...Show more
    Last updated: 19 days ago • Promoted
    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,587 to $1,760 per week in Rio Rancho, NM

    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,587 to $1,760 per week in Rio Rancho, NM

    TravelNurseSource • Rio Rancho, NM, US
    Full-time
    TravelNurseSource is working with LRS Healthcare to find a qualified ICU / Critical Care RN in Rio Rancho, New Mexico, 87144!. Ready to start your next travel adventure? LRS Healthcare offers a full b...Show more
    Last updated: 6 days ago • Promoted
    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,708 to $1,910 per week in Roswell, NM

    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,708 to $1,910 per week in Roswell, NM

    TravelNurseSource • Rio Rancho, New Mexico, US
    Full-time
    TravelNurseSource is working with Prime Time Healthcare to find a qualified ICU / Critical Care RN in Roswell, New Mexico, 88201!. Now Hiring : RN ICU - Roswell, NM.Contact us for Pay Information.Actua...Show more
    Last updated: 6 days ago • Promoted
    Registered Nurse

    Registered Nurse

    Encompass Health • Edgewood, NM, US
    Full-time +1
    Registered Nurse Career Opportunity.Now offering a $10,000 Sign on Bonus!.Respected and valued for your Registered Nurse skill set. Are you looking for a career thats close to your heart and close t...Show more
    Last updated: 19 days ago • Promoted
    CDL-A Truck Driver - Home Weekly - $44,337-$71,955 / Year - 4 Months Exp

    CDL-A Truck Driver - Home Weekly - $44,337-$71,955 / Year - 4 Months Exp

    System Transport • Tijeras, NM, US
    Full-time
    System Transport is Now Hiring Regional CDL-A Truck Drivers!.Flatbed CDL-A Driver - Home Weekly!.Earn $44,337 - $71,955 per Year - Full Benefits. Experienced flatbed CDL-A drivers.Medical, dental, v...Show more
    Last updated: 10 days ago • Promoted
    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,725 to $1,912 per week in Los Alamos, NM

    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,725 to $1,912 per week in Los Alamos, NM

    TravelNurseSource • Albuquerque, New Mexico, US
    Full-time
    TravelNurseSource is working with LRS Healthcare to find a qualified ICU / Critical Care RN in Los Alamos, New Mexico, 87544!. Ready to start your next travel adventure? LRS Healthcare offers a full b...Show more
    Last updated: 6 days ago • Promoted
    Clinical Reimbursement Coordinator, RN

    Clinical Reimbursement Coordinator, RN

    Ladera Center • Albuquerque, NM, United States
    Full-time
    Ladera Care Center seeks a part time MDS Nurse!.At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service.As a leadin...Show more
    Last updated: 30+ days ago • Promoted
    Registered Nurse, RN

    Registered Nurse, RN

    Ladera Center • Albuquerque, NM, US
    Full-time
    Join the team at Ladera Care Center as a Part Time RN!.At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service.As a...Show more
    Last updated: 1 day ago • Promoted
    Registered Nurse, RN

    Registered Nurse, RN

    Bear Canyon Rehabilitation Ctr • Albuquerque, NM, US
    Full-time
    Bear Canyon Rehabilitation seeks Part Time RNs on day and night shifts!.At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and excepti...Show more
    Last updated: 1 day ago • Promoted
    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,907 to $2,028 per week in Los Alamos, NM

    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,907 to $2,028 per week in Los Alamos, NM

    TravelNurseSource • Albuquerque, New Mexico, US
    Full-time
    TravelNurseSource is working with Fusion Medical Staffing to find a qualified ICU / Critical Care RN in Los Alamos, New Mexico, 87544!. Facility in Los Alamos, New Mexico.Fusion Medical Staffing is se...Show more
    Last updated: 6 days ago • Promoted
    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $2,392 to $2,673 per week in Los Alamos, NM

    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $2,392 to $2,673 per week in Los Alamos, NM

    TravelNurseSource • Albuquerque, New Mexico, US
    Full-time
    TravelNurseSource is working with Prime Time Healthcare to find a qualified ICU / Critical Care RN in Los Alamos, New Mexico, 87544!. Now Hiring : RN ICU - Los Alamos, NM.Contact us for Pay Information...Show more
    Last updated: 6 days ago • Promoted
    Registered Nurse, RN

    Registered Nurse, RN

    Albuquerque Hghts HC and Rehab • Albuquerque, NM, US
    Full-time
    Join Albuquerque Heights Healthcare and Rehabilitation as a Part Time RN on Day and Night shifts!.At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of hig...Show more
    Last updated: 1 day ago • Promoted
    Regulatory Quality RN Clinical Care-Intermediate

    Regulatory Quality RN Clinical Care-Intermediate

    Presbyterian Healthcare Services • Albuquerque, NM, US
    Full-time
    Regulatory Quality RN Clinical Care-Intermediate.Responsible for PH Quality of Clinical Care (QOCC) activities.Investigates complaints alleging inappropriate Physical Health (PH) clinical care or a...Show more
    Last updated: 16 days ago • Promoted
    Registered Nurse (RN) - Hourly rate range $34 - $50

    Registered Nurse (RN) - Hourly rate range $34 - $50

    Encompass Health • Cedar Crest, NM, US
    Full-time +1
    Registered Nurse Career Opportunity.Now offering a $10,000 Sign on Bonus!.Respected and valued for your Registered Nurse skill set. Are you looking for a career thats close to your heart and close t...Show more
    Last updated: 19 days ago • Promoted
    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,773 to $1,886 per week in Silver City, NM

    Travel Registered Nurse (RN) - Intensive Care Unit (ICU) / Critical Care - $1,773 to $1,886 per week in Silver City, NM

    TravelNurseSource • Rio Rancho, New Mexico, US
    Full-time
    TravelNurseSource is working with Fusion Medical Staffing to find a qualified ICU / Critical Care RN in Silver City, New Mexico, 88061!. Facility in Silver City, New Mexico.Fusion Medical Staffing is ...Show more
    Last updated: 2 days ago • Promoted
    RN

    RN

    Target • Albuquerque, NM, US
    Part-time
    Pay is based on several factors which vary based on position.These include labor markets and in some instances may include education, work experience and certifications. In addition to your pay, Tar...Show more
    Last updated: 22 hours ago • Promoted • New!
    Care Review Clinician (RN)

    Care Review Clinician (RN)

    Molina Healthcare • Los Lunas, New Mexico, United States
    Full-time
    For this position we are seeking a (RN) Registered Nurse who must hold a compact license.This is a Remote position, home office with internet connectivity of high speed required.Work Schedule Monda...Show more
    Last updated: 6 days ago • Promoted
    Registered Nurse (RN) - Hiring for Full-Time and PRN, Days and Nights

    Registered Nurse (RN) - Hiring for Full-Time and PRN, Days and Nights

    Encompass Health • Cedar Crest, NM, US
    Full-time +1
    Registered Nurse Career Opportunity.Now offering a $10,000 Sign on Bonus!.Respected and valued for your Registered Nurse skill set. Are you looking for a career thats close to your heart and close t...Show more
    Last updated: 19 days ago • Promoted