This role focuses on nursing-led quality improvement and investigations work, with an emphasis on reviewing care processes, identifying issues, and supporting follow-up actions that improve clinical quality. The work is remote and centered on coordinating across teams, using data and documentation to support investigation, remediation, and ongoing performance improvement.
Key Responsibilities
- Conduct quality improvement investigations related to care delivery and clinical processes.
- Review records, documentation, and case details to identify trends, gaps, and potential issues.
- Coordinate follow-up actions with internal teams to support corrective measures and resolution.
- Use data and reporting tools to track findings, monitor progress, and support quality initiatives.
- Participate in cross-functional collaboration to address quality concerns and improve outcomes.
Required
- Current RN licensure.
- Experience in nursing, quality improvement, investigations, or a related clinical role.
- Ability to work in a remote environment.
Preferred
- Experience with national quality improvement programs or healthcare investigations.
- Background in managed care, utilization management, or health plan quality work.
- Familiarity with data review, reporting, and documentation workflows.