Risk Management Nurse/Quality Manager

About the role

The Clinical Quality Manager (CQM) is a registered nurse who works full time and has the authority and responsibility to identify and implement strategies that control conditions and behaviors which may expose the organization, facility, and staff to risk or financial loss. Working with the Administrator and Director of Nursing, the CQM ensures resident care objectives are met in accordance with facility standards, policies, and current care practices. The CQM identifies potential or actual risks to residents, staff, and visitors, monitors key areas of resident care, and implements training programs to mitigate risks.

The CQM reports directly to the Quality Management Coordinator.

Responsibilities

• Provides guidance and assists in the implementation and monitoring of resident care objectives, clinical standards, policies, and procedures for Nursing Services, consistent with facility and current care standards.
• Embraces the facility’s philosophy to deliver care that promotes each resident’s clinical status and quality of life.
• Establishes, with the Administrator and Director of Nursing, a mechanism to monitor care delivery in compliance with state, federal, and facility standards.
• Monitors systems of care, objectives, policies, procedures, staffing patterns, and orientation based on resident needs.
• Identifies potential and actual risks to residents, staff, and visitors.
• Monitors and may deliver care, ensuring documentation aligns with current nursing standards.
• Communicates findings to the Quality Management Coordinator and facility Administrative Team.
• Encourages and trains staff to perform care functions that enhance resident quality of life while reducing litigation risks.
• Conducts daily rounds to identify risks, deficient practices, and documentation issues; designs and implements training programs to address them.
• Meets regularly with the Administrator, Director of Nursing, and Quality Management Coordinator to address risks and deficiencies, offering recommendations for mitigation.
• Collaborates with the Director of Nursing and Administrator to implement risk-reduction practices.
• Establishes and administers a process for receiving, documenting, tracking, investigating, and acting on complaints or reports of potential liability risks.
• Investigates identified risks and recommends corrective actions to reduce financial loss.
• Identifies educational opportunities for staff and develops/delivers in-service training.
• Serves as a member or liaison to the Corporate Compliance Committee and as the information privacy liaison for clinical/administrative systems under the Privacy Officer’s direction.
• Maintains current knowledge of federal and state laws, Medicare certification standards, and monitors compliance.
• Serves as a clinical consultant to all facility clinical staff.
• Represents the facility’s interests with external parties (e.g., government bodies) during audits, surveys, or compliance monitoring.
• Performs other duties as assigned by the Director of Nurses, Quality Management Coordinator, or Administrator.

Requirements

• Comprehensive knowledge of nursing practices for aged, chronically ill, and convalescent residents.
• General knowledge of Medicare/Medicaid programs and current federal/state regulations for skilled (SNF) and nursing (NF) facilities, including the Nursing Home Care Act, Oklahoma Nurse Practice Act, and OSHA’s Bloodborne Pathogen Standards.
• Familiarity with facility policies and procedures to ensure compliance in resident care.
• Knowledge of the legal process and ability to identify liability risks.
• Strong interpersonal and leadership skills.

Qualifications

• Licensed as a Registered Nurse in Oklahoma; must maintain good standing with the Oklahoma Board of Nursing.
• Two years of experience in long-term care, risk management, legal issues, and direct resident care preferred.
• Moderate computer literacy to complete online tasks and documentation.
• Ability to communicate and interact professionally with staff and residents.

Physical Requirements

• May be required to lift, carry, turn, or assist high-risk residents.
• Able to sit, stand, bend, and move intermittently during work hours.
• Able to lift, push, and carry 40 pounds with two hands and 20 pounds with one hand.
• Willing and able to work a flexible schedule.

All candidates must be able to perform the full range of job functions outlined in this description.