Covenant Health

Manager of Quality and Care Management, Quality Management

Full time, 80 Hours per pay period, Day shift

Claiborne Medical Center Overview:

Claiborne Medical Center, a member of Knoxville-based Covenant Health, offers a full range of medical services including emergency care, general and orthopedic surgery, rehabilitation, and diagnostic services. Our radiology services are certified by the American College of Radiology in Computerized Tomography (CT), Mammography, Magnetic Resonance Imaging (MRI), Nuclear Medicine, and Ultrasound. Claiborne also provides skilled and long-term care through Claiborne Health and Rehabilitation Center. Our team of physicians and staff is dedicated to putting our patients first, every day.  For more information, visit ClaiborneMedicalCenter.com.

Position Summary:

Responsible for the planning, organization, management, and evaluation of operations of quality, care management, infection prevention, performance improvement, regulatory compliance, and medical staff services of assigned facilities. Responsible for the coordination of care and outcomes of clinical and operational metrics for all patients through the continuum of care. Knowledgeable in quality improvement principles, regulatory, and Care Management standards. The manager is responsible for budget management, staffing, hiring, discipline, and performance management for applicable departments. The Quality Manager/Care Manager is responsible for collaborating with appropriate enterprise leaders when applicable.

When the Quality Manager does not have oversight of Care Management, those applicable accountabilities and performance criteria are non-applicable.

Recruiter: Jennifer Lawless || jlawles2@covhlth.com || 423-492-5011

• Develops department budgets that reflect effective management of resources to provide services.
• In collaboration with enterprise leadership, facility leadership, and medical staff, assists in the development of strategic initiatives for the department and facility.
• Collaborates with interdisciplinary groups and leaders to identify and monitor key processes and patient outcomes. Uses various data sources, including but not limited to, publicly reported data to inform which processes and outcomes to monitor. Facilitates effective communication of results to medical staff and other key stakeholders.
• Identifies opportunities for improvement using Covenant performance improvement methodologies to implement corrective action plans and evaluate results for desired outcomes.
• Manages Care Management functions to ensure the coordination of care for patients so they move seamlessly through the continuum of care.
• Stays abreast of regulatory, licensing, and certification (Joint Commission, CMS, Leapfrog, State, etc.) standards to ensure processes are in place to achieve desired outcomes.
• Collaborates with the Peer Review/PQPR medical staff chair to operationalize assessments of peer review triggers and functions of the facility medical staff.
• Collaborates with clinical and medical staff to implement processes, as needed, to ensure financial and length of stay metrics are assessed and communicated to applicable medical staff and organizational leaders.
• Operationalizes a Care Management Model to ensure timely and effective throughput through the continuum of care. Serves as a coach, mentor, and role model for all team members.
• Oversees activities of medical staff credentialing, FPPE/OPPE, and departmental organization including, but not limited to, facilitating applicable medical committee meetings to ensure effective patient safety and regulatory compliance.
• Collaborates with enterprise infection prevention management and local leaders to assess and support the infection prevention strategies as needed.
• Oversees survey action plans and ongoing assessments of regulatory readiness for all accreditation, certification, and state surveys.
• Collaborates with nursing, medical staff, and other disciplines to assess and improve outcomes related to performance with various measures associated with publicly reported entities.
• Proactively seeks opportunities to reduce waste and redundancy in the utilization of resources.
• At a minimum participates in the Quality, Peer Review, Regulatory, Infection Prevention, and Credentials Committees. The Quality Manager may serve as the committee facilitator as needed.
• Communicates with medical staff to improve utilization of resources and compliance with evidenced based care as deemed necessary.
• Collaborates with medical staff and facility leadership to determine the frequency, quality, and monitoring of multidisciplinary rounds.
• Provides data to stakeholders on an ongoing basis to inform stakeholders on progress towards applicable enterprise and business unit clinical and operational goals.
• Local travel required.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Minimum Education:

Bachelor’s degree or higher in Nursing, Social Work, Healthcare Administration, Public Health, or other related field.

Minimum Experience:

A minimum of five (5) years of experience with at least three (3) years in a hospital setting.

Licensure Requirement:

Must have and maintain a valid Tennessee RN license if degree is in Nursing. CCM, ACM, or CPHQ certification preferred. Employee must have a valid Tennessee driver’s license and state mandated minimum insurance coverage. Driving record must meet Covenant Health minimum standards at the date of hire and throughout employment tenure.