Quality Critical Incident Clinical Coordinator
Full Time
Albuquerque, NM 87113
Posted
Job description
Overview:
Critical Incident Reporting is a Contractual requirement within the State of New Mexico and Presbyterian Health Plan Centennial Care Medicaid Contract. Critical Incidents include but are not limited to reports of abuse, neglect, and exploitation towards a Member. This Registered Nurse position is responsible for the coordination of a variety of aspects of the Critical Incident Reporting process, initiatives and specialized program activities with minimal oversight and independent judgement. Responsible for processing of daily assignment of Critical Incidents timely and accurately to ensure Members healthcare and safety needs are met and contractual timelines are met.
Type of Opportunity: Full Time
FTE: 1.000000
Exempt: Yes
Work Schedule: Weekday Schedule Monday-Friday
Qualifications:
We offer more than the standard benefits!
Learn more about our employee benefits:
https://www.phs.org/careers/employee-benefits/Pages/default.aspx
Why work at Presbyterian?
Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.
About Presbyterian Healthcare Services
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
About Our Regional Delivery System
We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.
About New Mexico
Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.
New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.
Critical Incident Reporting is a Contractual requirement within the State of New Mexico and Presbyterian Health Plan Centennial Care Medicaid Contract. Critical Incidents include but are not limited to reports of abuse, neglect, and exploitation towards a Member. This Registered Nurse position is responsible for the coordination of a variety of aspects of the Critical Incident Reporting process, initiatives and specialized program activities with minimal oversight and independent judgement. Responsible for processing of daily assignment of Critical Incidents timely and accurately to ensure Members healthcare and safety needs are met and contractual timelines are met.
Type of Opportunity: Full Time
FTE: 1.000000
Exempt: Yes
Work Schedule: Weekday Schedule Monday-Friday
Qualifications:
Asociates Degree Required
Current New Mexico RN License required. Three to five years experience in clinical nursing field required, three years quality improvement experience preferred. Demonstrated ability to apply Nursing judgement to complex member situations. Knowledge of case management and care coordination concepts and activities preferred. Excellent written, oral, and facilitation skills required. Proficiency in Microsoft in Word, Excel, and Outlook required. Demonstrates ability to work with highly sensitive and confidential information.
Responsibilities:
Current New Mexico RN License required. Three to five years experience in clinical nursing field required, three years quality improvement experience preferred. Demonstrated ability to apply Nursing judgement to complex member situations. Knowledge of case management and care coordination concepts and activities preferred. Excellent written, oral, and facilitation skills required. Proficiency in Microsoft in Word, Excel, and Outlook required. Demonstrates ability to work with highly sensitive and confidential information.
- Under the supervision of Critical Incident Management RN Supervisor, this position is responsible for applying clinical judgement to Critical Incident Reports.
- Completes daily processing of incoming Critical Incidents on the NM CIR Portal and refers all Critical Incidents for appropriate follow up activities with Care Coordination, Providers, Adult Protective Services, Children Youth and Families Department, and/or other quality workflows as needed.
- Documents all pertinent Critical Incident data and information in the PHP internal database.
- Upon gained knowledge and expertise will process more complex Critical Incidents.
- Collaborates with the Quality of Clinical Care (QOCC) Team to identify and refer appropriate referrals from CIR for QOC investigation.
- Actively participates and collaborates with the CIR team in routine team and department meetings to identify issues, trends, best practices, and process improvement activities.
- Performs other duties as assigned.
We offer more than the standard benefits!
Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!
Learn more about our employee benefits:
https://www.phs.org/careers/employee-benefits/Pages/default.aspx
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.
Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.
About Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
About Our Regional Delivery System
Presbyterian's Regional Delivery System is a network of six hospitals and medical centers throughout rural New Mexico including locations in Clovis, Espanola, Ruidoso, Santa Fe, Socorro and Tucumcari. Our regional facilities are home to more than 1,600 clinical and non-clinical employees who help make Presbyterian the state's largest private employer with nearly 14,000 statewide employees. With a variety of services ranging from general surgery to pediatrics to heart and cancer care, our regional employees are proud to provide close-to-home care for their communities.
We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.
About New Mexico
New Mexico continues to grow steadily in population and features a low cost-of living.
Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.
New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
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