A Quality Management Analyst at Presbyterian Healthcare Services (PHS) in Albuquerque plays a crucial role in ensuring high standards of healthcare delivery. They are responsible for Quality Assurance, Quality Improvement, and collaborative Educational initiatives, supporting compliance with Federal and State regulations, Joint Commission Accreditation standards, and PHS policies and procedures. Sound like a fit for you? Apply now!
Type of Opportunity: Full Time FTE: 1.0
Exempt: Yes
Work Schedule: Days
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.
Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.
About Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
About Our Regional Delivery System
Presbyterian's Regional Delivery System is a network of six hospitals and medical centers throughout rural New Mexico including locations in Clovis, Espanola, Ruidoso, Santa Fe, Socorro and Tucumcari. Our regional facilities are home to more than 1,600 clinical and non-clinical employees who help make Presbyterian the state's largest private employer with nearly 14,000 statewide employees. With a variety of services ranging from general surgery to pediatrics to heart and cancer care, our regional employees are proud to provide close-to-home care for their communities.
We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.
About New Mexico
New Mexico continues to grow steadily in population and features a low cost-of living.
Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.
New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.
How you grow, learn and thrive matters here.
Text 505.388.0350 or schedule directly with me by clicking here!
In conjunction with Director of PHH Quality and Medical Records, analyze, plan, develop, coordinate, implement and evaluates compliance with accreditation, regulatory and licensing requirements, policies, procedures and protocols, and recommends educational opportunities.
In conjunctions with Directors, Managers, and Supervisors, analyze, monitor, coordinate, or conduct audits and/or surveillance to assess sustained compliance with regulations, policies, procedures, and protocols to determine if documentation and practice meets current clinical standards of care. Document findings appropriately.
Research and stay up-to-date with current industry standards and regulations, and serve as a subject matter expert and staff resource for PHH. Collaborate with Operations to help ensure accurate and consistent service provision, charting and data entry to result in timely processing of claims that meet regulatory and licensing requirements, policies and procedures and protocol requirements.
Assist in evaluating, writing, and revising clinical and non-clinical policies/procedures for PHH.
Collaborate with Education Department, Directors, Managers and Supervisors to recommend and or conduct clinical education, competency and training elements for orientation and ongoing clinical staff.
Guide and assist Directors, Managers, Supervisors and Staff with utilization of Quality Assessment and Performance Improvement (QAPI) tools and processes. Develops materials and/or tools to assist staff with utilizing QAPI processes such as: audit tools, staff and/or patient educational newsletters or handouts, or training materials.
Participates on committees, councils, PHS initiatives, or projects. Perform root cause analysis and/or risk assessments of adverse clinical events and or compliant investigations, and serve as the PHH liaison for environment of care, emergency preparedness, and infection control oversight..
Track, trend and analyze data, and submit reports with recommendations to Directors, Managers, and Supervisors to help PHH achieve and maintain compliance with accreditation, regulatory and licensing requirements, policies, procedures and protocols, through incorporation of Outcome-based and Quality Improvement (OBQI) practices. Upon request, participates in reviews of the patients medical record and/or case conferences conducted by clinical teams, to present findings, and if necessary, offer recommendations for improvement. Coordinate mandatory regulatory reporting preparation, transmission and follow-up. Research and collaborate with staff to correct incomplete or incorrect data to finalize all required processing. Collaborate with Operations to help ensure accurate and timely processing of claims to meet regulatory requirements.
Provide coverage for Quality Management activities during absence of the Director of PHH Quality and Medical Records.
Associates degree in Nursing, BSN preferred
New Mexico Nursing License required, RN-NM
1 year related experience
OASIS certification within 18 months of hire for those supporting the Home Healthcare Team
We're all about well-being, starting with yours.
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.
Learn more about our employee benefits.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses.
Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
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