Position Summary

Reporting to the Regional Clinical Director, the Regional Clinical Quality Manager supports ongoing quality improvement initiatives, compliance with state and federal regulations, NCQA accreditation requirements and reinforcement of clinical best practices and Careforth policies and procedures. The Regional Clinical Quality Manager works closely with the Regional Clinical Director to coordinate and implement an approach to improved quality and compliance outcomes for their assigned region.

What You Will Do:

• In collaboration with the Regional Clinical Director, supports effective deployment of clinical quality and compliance initiatives through partnerships with clinical staff and key stakeholders and monitors quality indicators and outcomes to identify improvement efforts 
• Supports application of consistent clinical practices as needs arise and advises care management teams on established policies, best practices, and appropriate documentation consistent with regulatory requirements and NCQA accreditation standards 
• Assists operations managers and the Regional Clinical Director to monitor incident reports, complaints, and compliance inquires; serves as resource for providing feedback on documentation to drive quality improvement 
• Based on internal audit findings, provides follow-up education to care management teams and serves as a resource for developing corrective action plans 
• Assists Regional Clinical Director with identification of process or training needs using gap analysis methodologies; escalates issues or areas of concern to management team as needed 
• Perform other duties as assigned

What You Will Bring:

• Must hold an active Registered Nurse (RN) license in a state within assigned region ( OH or IN)
• 4-6 years of recent experience in direct care of elders or adults with disabilities
• General knowledge of care management principles with demonstrated experience designing and developing quality improvement projects required; Knowledge of NCQA, governing and regulatory agency requirements preferred 
• Strong analytical and creative problem-solving skills; Ability to identify opportunities for improvement and measure results 
• Proficiency with Microsoft Office (e.g. PowerPoint, Word, and Excel) and medical documentation systems is required; Salesforce experience is a plus 
• Strong written and verbal communication skills; excellent interpersonal skills with customer focus and ability to develop strong working relationships with cross-functional teams 
• Ability to travel periodically within assigned geographic area mostly by automobile but may include air travel or overnight travel; valid driver’s license and automobile insurance is required.

You'll Benefit From:

At Careforth your well-being matters. With flexible schedules, a remote-first culture, and a nationally recognized wellness program, our benefits are designed to help you thrive, both professionally and personally. Discover how we invest in you: https://careforth.com/careers/#benefits

The pay range for this position is $75, 270 - $92,215 . The actual wage offered may be lower or higher depending on budget and candidate experience, knowledge, skills, qualifications, and geographic location.