Quality /Case / Outcomes / Risk Management

South GA multi-hospital system seeks quality professional to assume leadership of their quality programs. This position is responsible for Core Measure Abstraction & Education; Implementation of QI program in the organization; Medical Staff Review; Oversight & Leadership of Case & Risk Management Departments and Oversight of system-wide JCAHO compliance. Requirements for this position include bachelor's degree-either in Nursing or Management; at least 4 yrs. full-time experience in healthcare; 2 yrs. QI experience & at least 3 yrs. management experience. CPHQ desired. TJ300

Growing health plan seeks 2 QI professionals, IN & MA, to build & lead their QI department. Reporting directly to VP, Medical Affairs, the Director will manage Grievance & Appeals, Credentialing & QI Coordinators as well as lead all initiatives for the plan. Requirements for this rare opportunity include: bachelor's prepared RN, master's preferred; 5 + yrs. experience in healthcare operations, including 3 + yrs. in quality & 3 + yrs. in leadership role. Must have direct knowledge of or experience with HEDIS & NCQA Accreditation procedures. DVP2200

A newly created position to provide administrative oversight to the Quality Dept. of this 350-bed not-for-profit hospital. Responsible for all regulatory & core measures; pay per performance & quality. Requirements include: RN with minimum 5 yrs. recent experience in an acute care quality department. 3-5 yrs. senior management required, BSN and masters in health related field also required. CPHQ preferred. HL300

220-bed not-for-profit hospital seeking Magnet status has a new position responsible for directing nursing quality initiatives. This position will require a BSN with 3-5 yrs. hospital clinical practice; 3 yrs. QA experience and MSN strongly preferred. HL400

400-bed hospital in SC has an opportunity for a BSN with 5 yrs. case management experience in an acute care facility &5 yrs. management experience to oversee their CM Dept of 8 employees. BSN required, MS preferred. This position reports to the CFO. HL450

Southern CA facility searching for a VP, Quality to design, implement & oversee all aspects of the QA & PI Departments. Position reports to CEO and has responsibility for development of an integrated approach to quality and patient safety across the organization as well as all facets of QM, RM, Medical Staff Services and Patient Safety including activities in: clinical excellence and patient safety; process improvement and outcomes management; regulatory readiness. LK600

One of the country's premier managed healthcare companies is looking for a quality professional to identify and develop processes that will achieve and maintain accreditation with NCQA and URAC. This individual will coordinate and monitor QI and organizational projects from inception to closure and create metrics to monitor clinical outcomes. Requirements are: 4 + years in managed care quality, knowledge of URAC/NCQA and clinical outcomes. CPHQ and experience coordinating project plans preferred. DVP2250

180-bed, JCAHO accredited hospital is seeking an experienced quality professional responsible for Regulatory Compliance, Employee Health, Infection Control, Risk Management, Medical Staff Coordination. BSN required, Masters preferred plus 10 yrs. nursing experience, 3-5 yrs. in Quality Certifications & BLS /CPR certification maintained. Position reports to CEO. CM1100

Managed Care Organization in Central OH offers an opportunity to provide leadership for their QI Dept. including directing daily activities; setting performance expectations; and ensuring compliance with Company, State, Federal & HEDIS requirements; NCQA and/or JCAHO standards; Position qualifications include: current RN license and CPHQ certification; 3-5 yrs; nursing experience; 1-3 yrs. recent QI and management experience in a healthcare environment, preferably managed care. DVP2260

Management opportunity for an experienced UM professional to join a well established health plan, with operations in over 10 states, to direct day-to-day activities of the Department including: review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives; Develop, implement and maintain UM programs to facilitate use of appropriate medical resources and decrease health plan exposure. Requirements include, RN license, prior supervisory experience, 3-5 yrs. UM OR CM and recent nursing experience in an acute care setting, particularly medical/surgical and pediatrics or obstetrics. Must have thorough knowledge of UM and clinical nursing; familiar with Medicare and Medicaid managed care practices and policies; CHIP & SCHIP. Exceptional growth potential.