RN Clinical Quality Manager
About The Position
VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. As RN Clinical Quality Manager, you will safeguard the accuracy of Quality Assurance data and reporting while advancing VillageCareMAX's overall quality strategy. Reporting to the Director for Quality, you'll partner across clinical and business teams to integrate improvement efforts and strengthen provider collaboration.
Requirements
- BSN; active NYS RN license (CPHQ preferred)
- 3-5 years in quality performance improvement with HEDIS/Stars; 2 years direct hybrid record review
- Strong metrics orientation, campaign management experience, and MS Office proficiency
Nice To Haves
- CPHQ preferred
Responsibilities
- Lead performance improvement work for MLTC or Medicare products; drive HEDIS/Stars gap closure
- Analyze claims and quality reports to identify trends, barriers, and opportunities
- Design and oversee initiatives, including HEDIS roadmaps, supplemental data collection, and chart retrieval
- Serve as day-to-day liaison for CMS external audit requests; maintain audit readiness and controls
- Facilitate cross-functional working sessions and guide staff producing quality analyses
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
