Supervisor - Quality Critical Incident

Location Address:

9521 San Mateo NE Albuquerque, NM

Minimum Offer $67,100.80

Maximum Offer $

Lead Patient Support Critical Incident Reporting is a Contractual requirement within the State of New Mexico and Presbyterian Health Plan Medicaid Contract. Critical Incidents include but are not limited to reports of abuse, neglect, and exploitation towards a Member. This position performs supervision in the training, coordination, and daily operational activities of the Critical Incident Reporting (CIR) team to ensure that tasks are assigned and carried out.

Ensures that Critical Incidents are processed and handed off to the appropriate workflow to make certain that the healthcare and safety needs of the most vulnerable Medicaid Members are met, and that the contractual required timelines are in compliance. Oversight of teams includes developing and maintaining models for tracking of staff performance. Assists the Manager and Director to apply performance measurements and/or ensure that the Critical Incident Reporting processes meet timeliness and quality standards.

Type of Opportunity: Full time

Job Exempt: Yes

Job is based: Reverend Hugh Cooper Administrative Center

Work Shift: Weekday Schedule Monday-Friday (United States of America)

• Under the direction of the Quality Manager, is responsible for and supervises Critical Incident Reporting activities.
• Monitors staff case load and distributes daily work assignments to the team to meet regulatory timeliness requirements for critical incident reports
• Ensures completion of daily processing of Critical Incidents from all sources including the NM CIR Portal and supervises referrals of all Critical Incidents for appropriate follow up activities with Care Coordination, Providers, and/or other quality workflows as needed
• Oversees documentation of all pertinent Critical Incident data and information in the PHP internal database
• Ensures all new CIRs are placed under review within 24 hours of receiving them, Monday-Friday excluding holidays
• Oversees closure of all CIRs via the HSD Critical Incident Reporting System (CI Portal)
• Trains staff in departmental application of systems, processes, policies and procedures, and assist in training of computer activities
• Updates and coordinates on-going improvement of CI processes including P&Ps, Desktops, Job Aids, Promise Map, etc
• Prepares for and participates in Monthly and Quarterly CI Committee Meetings. Assists with analysis and writing of HSD Report 36
• Attends and actively participates at quarterly HSD/MCO CIR workgroup meetings.

• Nursing Degree required.
• Bachelors degree required, MSN or BSN preferred.
• Critical Incident Management experience required.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

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.

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are 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 1600 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.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.