Supervisor - Quality Critical Incident

Presbyterian is seeking a Supervisor - Quality Critical Incident!

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.

We're determined to take care of those working in healthcare.

Presbyterian is dedicated to improving people's lives - the lives of our patients and the lives of our coworkers. We're locally owned and operated, which encourages supportive leadership that emplowers employees. And we provide the opportunity to gorw from entry-level to the most senior positions.

Why Join Us

Full Time - Exempt: Yes
• Job is based at Rev Hugh Cooper Admin Center
• Work hours: Weekday Schedule Monday-Friday
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Prefer Qualifications

• Leadership experience
• Experience with working in an MCO (managed care organization)

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

• 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.
  
  

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.

Wellness
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.

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.

About Presbyterian Healthcare Services
Presbyterian exists to ensure the patients, members and communities we serve can achieve their best health. 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.

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.