Supervisor, Quality Improvement (RN)

Location: Tampa, FL, United States
Position Purpose: Oversee the day-to-day quality review function, ensuring accurate and timely review of department processes to ensure compliance with applicable state, federal and accrediting body requirements. 
  • Provide supervision for appeals and grievance, quality of care/service; provider redeterminations and other applicable department activities including policies, procedures, workflows, letters, and reports.
  • Communicate and reinforce standards for the quality team
  • Prepare any applicable department state, federal, or accrediting body reports and submit timely. 
  • Prepare other quality review reports on departmental findings, identifying individual and organizational trends
  • Identify and analyze team performance trends, address barriers, and recommend process improvements.
  • Ensure non-clinical and clinical audits are conducted according to established tools and standards
  • Provide recommendations for development, or revision of policies, procedures, work flows, documents or other documents to be used for training content or skill acquisition 
  • Research and respond to complex quality of care or quality of service, appeal and grievance or provider redetermination inquiries.
  • Coordinate with management to ensure the department output is meeting goals, expectations and requirements in alignment with the quality improvement department and program description and work plans.
 
Qualifications:
Education/Experience:
  • LPN/LVN or graduate from an Accredited School of Nursing and RN License.
  • Bachelor’s degree in related field preferred.
  • 5+ years of clinical experience in health care.
  • Managed care experience preferred.
  • Previous experience in supervisory role, quality assurance preferred.
  • Strong computer skills, including experience with Microsoft office and/or quality monitoring systems

License/Certificates:
  • LPN/LVN or RN license without restriction in the state of residence.
  • RN Licensure is highly preferred. 

 
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