Quality Assurance Nurse Manager Overview • The Quality Assurance Nurse Manager oversees wellness and quality assurance initiatives within the organization. • Develop goals and outcomes using HEDIS specifications for quality improvement and corrective action plans. • Collaborate with providers to address quality-of-care concerns and enhance performance measures. • Supervise and provide clinical oversight to Registered Nurses and Health Educators. • Educate members on chronic conditions and promote healthier lifestyle behaviors. • Participate in health fairs, screenings, and outreach events to support community wellness. • Engage in seasonal vaccination and testing initiatives as required. • Analyze data, identify trends, and recommend quality enhancements to business leads. • Hybrid work schedule provides flexibility and work-life balance. Quality Assurance Nurse Manager Key Responsibilities & Duties • Coordinate and develop quality improvement goals using HEDIS specifications. • Review charts and population-based data for quality improvement processes. • Track and trend reported quality-related issues to identify gaps in care. • Serve as a clinical liaison between the organization and providers on quality concerns. • Supervise and oversee activities of Wellness RNs and Health Educators. • Educate members on acute and chronic conditions to promote healthier behaviors. • Participate in vaccination, testing, and outreach events as needed. • Collaborate with business leads to recommend quality enhancements based on data analysis. • Perform additional duties and projects as assigned by management. Quality Assurance Nurse Manager Job Requirements • Valid New York State Registered Nurse (RN) license required; Bachelor’s degree in Nursing preferred. • Minimum three years of quality improvement experience and two years of management experience. • Strong clinical assessment, patient education, and motivational interviewing skills. • Knowledge of HEDIS specifications and NCQA standards preferred. • Intermediate computer literacy and proficiency in Microsoft Outlook, Word, and Excel preferred. • Bilingual in Spanish preferred; valid NYS driver’s license preferred. • Ability to work flexible hours, including evenings and weekends as needed. • Experience in ambulatory care, community health care, or medical/surgical nursing. • Excellent communication skills for nurse-physician interactions.