Program Manager Patient Safety Nurse Health Plan - Health Plan Admin

Summary:

The Program Manager Patient Safety Nurse Health Plan will work in collaboration with the Manager of Health Plan Quality to assist in consistent development of the patient safety program according to contractual and accreditation requirements, review and assess patient safety medical record reviews and prepare summaries for the Medical Director and Peer Review Committee monthly. The Program Manager will prepare all cases for the Peer Review Committee, schedule meetings, prepare materials, take minutes that are in accordance with regulatory compliance and provide feedback to the provider, facility, Network, and credentialing departments, as appropriate. The Program Manager Patient Safety Nurse Health Plan will provide constant feedback on program progress and suggest action plans for any deviation from the set goal. The Program Manager will develop and coordinate educational activities for providers and staff that will enhance all aspects of patient safety program and program description. The Program Manager Patient Safety Nurse Health Plan will collaborate directly with the Manager Health Plans Quality, and other team members to ensure compliance with contractual and accreditation requirements are in place. This role will conduct routine readiness assessments, evaluations of procedures, and will complete all USFHP deliverables related to contractually required Patient Safety reporting.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Active collaborator with multiple internal departments to create and implement various programs /plans under the Quality program/banner.
• Observe and Identify trends and potential strategies for Patient Safety issues by collaborating with the Health Plan Quality Manager, Director of Health Plan Quality, Chief Medical Officer, and health plan staff.
• Track and trend barriers/challenges that exist to achieve better outcomes, including access to databases, lack of follow up, or documentation.
• Develop and initiate patient safety programs for internal and external customers.
• Facilitate communication between providers and health plan to optimize patient safety, reduce inpatient admissions, reduce re-admissions, and improve medical stability in the patient population served.
• Responsible for coordinating patient safety data and evaluating the quality and completeness of clinical documentation processes.
• Participates in the development and ongoing implementation of quality improvement activities by providing regular and ongoing provider/staff support and education.
• Review and assess patient safety medical record reviews and prepare summaries for the Medical Director and Peer Review Committee monthly.
• Prepare all cases for the Peer Review Committee,
• Prepare all materials and schedule Peer Review meetings.
• Document via minutes the Peer Review meeting minutes and follow up actions in accordance with regulatory compliance.
• Provide feedback to the providers, facilities, Network, and credentialing departments, as appropriate.
• Communicate and follow through with assigned tasks.
• Perform all other related duties as assigned.

Job Requirements:

Education/Skills

• Associate degree in nursing required.

• Bachelor’s degree in nursing preferred.

Experience

• 2 years’ experience with Electronic Medical Record required.

• 4 years of clinical experience preferred.

Licenses, Registrations, or Certifications

• Registered Nurse Licensure required.

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time

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https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf

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