Full-Time
Quality Program Nurse
Registered Nurse
Deadline 8/10/27
IEHP
Compensation Overview
$91.2k - $120.9k/yr
California, USA
Remote
Remote within California, with automobile travel throughout the Inland Empire and periodic in-person meetings at the main campus.
Bachelor's, Associate's
Category
 Medical, Clinical & Veterinary |
|---|
Required Skills
Nursing
Quality Assurance (QA)
Requirements
- Three or more years of combined experience in Quality Assurance, Utilization Management, Case Management, provider liaison duties, and/or clinical experience in a hospital or clinical setting.
- An Associate’s degree in Nursing from an accredited institution is required.
- Possession of a valid Certified Site Reviewer Certificate issued by the Department of Health Care Services or a participating Medi-Cal Managed Health Plan Provider, or willingness and ability to obtain certification within six months of hire.
- An active, unrestricted, and unencumbered Registered Nurse license issued by the California Board of Registered Nursing is required.
- A valid California driver’s license and valid automobile insurance are required.
- Knowledge and understanding of nursing principles and evidence-based practices.
- Proficiency with spreadsheet, database, and word-processing applications.
- Strong organizational, time-management, and critical-thinking skills.
- Excellent written and verbal communication and interpersonal skills.
- Highly skilled in interpersonal communication, including conflict resolution.
- Ability to manage multiple projects, complete deadlines, and adapt to changing priorities.
- Ability to perform minimal to moderate physical activity, including standing, bending, sitting for long periods, and repetitive motion.
- Ability to travel by automobile within the Inland Empire.
Responsibilities
- Perform initial, periodic, and verification Facility Site Reviews and Medical Record Surveys for assigned Primary Care Providers, along with other regulatory audits as assigned.
- Review Primary Care Provider Corrective Action Plan submissions and monitor compliance.
- Perform focused audits as directed by IEHP Subcommittees.
- Perform annual Healthcare Effectiveness Data and Information Set data abstractions.
- Monitor assigned Primary Care Providers for potential problem hours and document findings.
- Review Quality Management reports and the Corrective Action Plan log weekly; maintain provider compliance and follow up.
- Attend and participate in Quality Management Committee and Subcommittee meetings as needed or directed.
- Attend Site Review and Medical Record Survey training mandated by the Department of Health Care Services to maintain and obtain Certified Site Reviewer status.
- Attend and participate in Quality Management, Medical Services, and other interdepartmental staff meetings as indicated.
- Perform other duties required to support successful plan operations.
Desired Qualifications
- Experience in a health maintenance organization or managed-care setting.
- A Bachelor’s degree in Nursing from an accredited institution.