Nursing Jobs in Oyster Bay, NY
$90,000 - $145,000 / year
191521 Job Description Serves as liaison between the patient and facility/physician. Ensures a continuum of quality patient care throughout hospitalization and oversees provisions for patient's discharge. Assesses, plans, oversees and evaluates the appropriateness of care throughout admission and hospitalization of the patient. Job Responsibility Facilitates patient management throughout hospitalization. Performs concurrent utilization management using evidence based medical necessity criteria. Submits data to management regarding case management and/or quality initiatives. Serves as an in-patient liaison - planning, assessing, implementing and evaluating patient in collaboration with the health care team. Conducts chart review for appropriateness of admission and continued length of stay; Facilitates throughput. Conducts clinical reviews and interacts with third party payers to obtain approval of hospital days, pre-certification and post-discharge eligibility in relation to clinical course. Ensures compliance with current state, federal, and third party payer regulations. Documents the case management process in the medical record; completes and documents a care coordination assessment on the patient. Serves as a liaison to patient, family, admitting, primary care physician, health care team, and hospital departments. Completes applicable areas of the patients discharge instruction sheet and the patient transfer sheet; ensures case management documentation is current and accurate. Manage a caseload of adult inpatients, coordinating care from admission through discharge with confidence and clinical insight Engage in complex discharge planning, collaborating with interdisciplinary teams to ensure seamless transitions and continuity of care Partner with your team and coworkers to coordinate scheduling, supporting one another to maintain balanced and effective coverage Adapt and contribute across units by floating to areas of need, broadening your skills and strengthening department-wide care delivery Share in weekend and holiday rotations on an alternating basis, ensuring our patients receive consistent, high-quality support every day of the year through self-scheduling Performs utilization management using Milliman guidelines and assessing medical necessity criteria and conducts chart review for appropriateness of admission and continued length of stay; Facilitates throughput. Documents the case management process in the medical record; completes and documents a care coordination assessment on patients and ensures documentation is current, accurate, meets CMS guidelines and is in-line with our department and intuitional standard of practice Collaborates with interdisciplinary team including daily rounds, participation in family meetings, staff meetings Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Complete PRI’s Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Job Qualification Graduate from an accredited School of Nursing. Bachelor’s Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two (2) years and obtain a BSN Degree within five (5) years of job entry date. Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. Emergency Department experience, preferred. Knowledge of Milliman guidelines, preferred Two years of experience in an acute care setting, preferred Ability to manage a diverse caseload, including complex discharge planning needs Strong time management, workflow, critical thinking and conflict resolution skills Team-oriented; able to coordinate self-scheduling collaboratively Flexible to float as needed Flexibility in days as needed Alternating weekends and holidays Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity). 
$112,008 - $134,409.60 / year
Description Coord, QM Welcome to Holy Name, a medical center where innovation is not just a goal — it's a commitment. Here, medical excellence thrives, allowing hope to reign supreme and leaving no room for fear. At our hospital, every patient is cared for with undivided attention — because healing every soul is our sole focus. Holy Name is New Jersey's only independent Catholic health system, comprising a 361-bed acute care hospital, a renowned cancer center, a state-of-the-art fitness center, a residential hospice, a prestigious nursing school, and an extensive physician network. Healing at Holy Name goes beyond medicine and technology – it is infused with faith, conviction, compassion, and a commitment to educating the next generation of healthcare professionals through a variety of residency and educational programs. Our mission to provide care for the body, mind, and soul spans education, prevention, diagnosis, treatment, rehabilitation, and overall wellness. This is at the core of who we are and what we do, and we've done it this way across generations, every single day, for nearly 100 years. Every innovation, medical breakthrough, and groundbreaking treatment is powered by some of the best minds in medicine, ensuring nothing is left on the table or the road to recovery. A Brief Overview The Quality Management (QM) Coordinator's over-aching aim is to advance the organization's commitment to healthcare quality through collaboration and communication. They will facilitate the integration of quality into the fabric of the organization through a coordinated infrastructure to achieve organizational objectives. The QM Coordinator helps coordinate the development, implementation, monitoring, and evaluation of Quality, Safety and Performance Improvement activities. This includes but is not limited to; supporting the performance improvement process, identifying performance trends, prioritizing, and recommending improvements, coordinating hospital-wide Performance Improvement activities regarding strategic initiatives and department goals, and participates in the root cause analysis (RCA) process for applicable serious safety events. Serving as a liaison to other hospital departments and personnel, they will use performance and process improvement (PPI), project management, and change management methods to support operational and clinical quality initiatives, improve performance, and achieve targeted organizational goals. The QM Coordinator will collaborate with key stakeholders to improve care processes by performing quality medical record reviews, assisting in the improvement of the clinical operations, maintaining accurate records of review activities, developing formal charters and improvement plans. They will also be responsible for maintaining up-to-date knowledge of regulatory standards and guidelines set forth by accrediting bodies. In collaboration with Leadership, Nursing, Medical Staff and other ancillary departments, they will prepare for, participate in, and follow up on regulatory, accreditation, and certification surveys and activities to facilitate continuous survey readiness. Serving as both a functional leader and data expert in a variety of tasks, namely; quality data reporting programs and measures, data compilation and analysis, process evaluation, and ongoing creation and maintenance of metric dashboards/displays of data to medical, clinical, and executive leadership and other committees as assigned. What You Will Do Plan, organize, and direct Quality Management activities to organize process improvement projects to ensure patient safety and improvement in quality metrics Collect, analyze, summarize and present data in a narrative, statistical and graphic format to identify trends, patterns, and areas in need of improvement Monitor and evaluate patient care outcomes and other performance indicators, working collaboratively with physician, nursing and other clinical and administrative professionals to develop and implement action plans to address changes in key indicators Support the development of dashboards and scorecards to monitor the progress of various quality initiatives and utilizing project management tools to track and communicate the status of those initiatives Represent Quality Management at Quality committees, departmental committees, performance improvement task forces and organizational teams as appropriate Conduct case reviews to investigate reported or suspected deviations in patient care outcomes, then facilitate appropriate review by physician and/or other professional staff, as appropriate based on clinical qualifications Participate in continuous readiness monitoring to ensure compliance with regulatory standards and accreditation requirements Facilitate the production of the department’s Quality & Patient Safety Annual Report Participates in Root Cause Analysis, investigates adverse events and implements corrective actions/interventions. Provide, facilitate, and evaluate formal and informal educational programs and presentations related to quality and patient safety to new hires and residents to facilitate opportunities to improve patient care Performs other duties as assigned Education Qualifications Bachelor's Degree in healthcare-related field Required Experience Qualifications Minimum of 5 years of experience in healthcare setting working directly with clinical, administrative and professional staff. Required Knowledge, Skills, And Abilities Excellent written, verbal and interpersonal skills Strong analytical skills Can do attitude, problem solver, role model, mentor and leader Proficient in Microsoft Excel, PowerPoint and Word Knowledge and application of performance improvement methodologies (High proficiency) Knowledgeable about state, federal, and regulatory agency requirements Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in state of NJ Upon Hire Required CPHQ - Certified Professional in Healthcare Quality within 1-1/2 Yrs Required At Holy Name, we believe in rewarding every team member with more than a paycheck—we invest in your future and well-being. Full-time and part-time employees have access to a comprehensive benefits package designed to support your health, financial security, and quality of life. We offer low-cost medical coverage with generous employer contributions, dental and vision plans, discounted prescriptions, and access to on-site child care. Additional benefits include 401(k) matching, tuition reimbursement, paid time off, flexible spending accounts, legal and voluntary coverage options, life insurance, and free on-site parking. If you are hired at Holy Name, your final base compensation will be determined based on factors such as employment status (Full/Part-Time or Per Diem) skills, education, and/or experience. In addition to those factors – we believe in the importance of pay equity and consider any internal equity of our current team members as a part of any final offer. Pay Range: $112,008.00 - $134,409.60 Holy Name is a mission-driven facility whose quality standards and philosophy are rooted in the principles of its founders, the Sisters of St. Joseph of Peace. Those principles are exercised daily by the Medical Center's dedicated and talented staff members. Holy Name is an Equal Opportunity Employer. 
