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 to control conditions and behaviors that may expose the organization, facility, and staff to risk or financial loss. In conjunction with the Administrator and Director of Nursing, the CQM ensures resident care objectives are met, consistent with facility standards, policies, and procedures, as well as current standards of care and practice.

The CQM identifies potential or actual risks that could cause harm to residents, staff, and visitors, monitors key areas of resident care, establishes training, and implements programs to mitigate risk. 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 regulatory standards.
• Embraces the facility’s philosophy to render care that promotes each resident’s clinical status and quality of life.
• Establishes, with the Administrator and Director of Nursing, a mechanism to monitor the delivery of care in compliance with state, federal, and facility standards.
• Monitors systems of care, objectives, policies, procedures, staffing patterns, and staff orientation based on resident needs.
• Identifies potential and actual risks to residents, staff, and visitors.
• Monitors and may deliver care consistent with current nursing standards, communicating findings to the Quality Management Coordinator and facility leadership.
• Encourages and motivates staff to perform care functions that enhance resident quality of life while reducing litigation risk.
• Conducts daily rounds to identify risks, deficient nursing 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 recommend corrective actions.
• Works cooperatively with leadership to implement practices that reduce or eliminate risk.
• 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 and administrative systems.
• Maintains current knowledge of federal and state laws, Medicare certification standards, and monitors compliance.
• Serves as a clinical consultant to facility 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 practice and its application to aged, chronically ill, and convalescent residents.
• General knowledge of the Medicare/Medicaid program and current federal/state rules 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 all aspects of 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 and in good standing with the Oklahoma Board of Nursing.
• Must maintain an active nursing license and provide evidence of renewal as required.
• Two years of prior 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.