Quality Program Nurse, RN (Remote with field work)

About the role

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Responsibilities

• Implement Quality Management policies, procedures, and activities under the direction of the Manager, Quality Management Nurses.
• Enforce DHCS regulatory requirements pertaining to Facility Site Review (FSR) and Medical Record Review (MRR) criteria.
• Support IEHP’s Quality Program goals, including HEDIS, CAHPS, and NCQA Accreditation.

Qualifications

• Three (3) or more years of any individual or combined experience in Quality Assurance, Utilization Management, Case Management, provider liaison duties, and/or clinical experience in a hospital/clinical setting.
• Experience preferably in an HMO or Managed Care setting.
• Associate’s degree in Nursing from an accredited institution required.
• Bachelor’s degree in Nursing from an accredited institution preferred.
• Possession of a valid Certified Site Reviewer Certificate issued from DHCS or a participating Medi-Cal Managed Health Plan Provider.
• If not a CSR, willingness and ability to obtain certification within 6 months of hire.
• Active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN required.
• Valid State of California driver's license and valid automobile insurance.

Skills

• Knowledgeable and understanding of nursing principles & evidence based practices.
• Computer applications: spreadsheet, database, and word processing.
• Strong organizational, time-management, and critical thinking skills.
• Excellent written and verbal communication and interpersonal skills.
• Highly skilled in interpersonal communication, including conflict resolution.
• Minimal to moderate physical activity; may include standing, bending, sitting for long periods of time and repetitive motion.
• Ability to manage multiple projects with completing deadlines and changing priorities.
• Automobile travel within the Inland Empire.
• May periodically be required to report to IEHP’s main campus for in-person meetings or for other business needs as determined by IEHP leadership.

Benefits

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Pay

Pay Range $91,249.60 USD Annually - $120,910.40 USD Annually