Quality Engagement Nurse/Risk Manager en Wood River Health

Wood River Health is is now seeking a Quality Engagement Nurse! If you are looking for a great work environment with work/life balance and fantastic benefits, this is the place!

Not only do we offer a great work environment, our benefits are fantastic! Packages include a generous paid time off program, health insurance, flexible spending account, life insurance, retirement 403(b), work/life balance, tuition assistance, and much more!

Wood River Health is committed to providing team-based, patient-centered care in alignment with the Patient-Centered Medical Home (PCMH) model. The Quality Engagement Nurse/Risk Manager combines clinical nursing expertise with comprehensive quality improvement and risk management responsibilities. This position leads data collection, patient outreach, internal audits, and risk management initiatives while maintaining organizational PCMH accreditation and ensuring compliance with FTCA requirements and quality standards. The role reports to the Chief Medical Officer and collaborates closely with the Quality Improvement Coordinator.

ESSENTIAL DUTIES; include but are not limited to:

Quality Improvement and Clinical Integration

• Track, document, and analyze quality measures within the Electronic Health Record (EHR) system
• Conduct targeted patient outreach to address care gaps, promote preventive services, and ensure continuity of care
• Perform audits and generate reports for UDS, HEDIS, NCQA, RIDOH, ACOs, and other regulatory and quality programs
• Participate in annual NCQA PCMH re-attestation process, coordinating with Chief Medical Officer, Quality Improvement Coordinator, and data analysts
• Design and implement Plan-Do-Study-Act (PDSA) quality and/or risk mitigation improvement projects based on data-driven insights
• Participate actively in Quality Management Committee meetings and pursue professional development in NCQA/PCMH, UDS, and quality methodologies
• Analyze quality metrics to identify trends, opportunities for improvement, and best practices

 Risk Management and Regulatory Compliance

• Develop, implement, and maintain Wood River Health's comprehensive Quality Improvement Plan and Safety and Risk Management Plan
• Work with the Chief Medical Officer to secure Governance Board approval for risk management plans every three years or when significant modifications occur
• Design and execute clinic-wide risk management program, including: 
  • Systematic identification and categorization of clinical, operational, and financial risks
  • Risk stratification and assessment methodologies
  • Development of risk mitigation strategies and monitoring protocols
• Provide recommendations to senior leadership and board committees regarding: 
  • Risk retention thresholds and self-insurance parameters
  • Insurance coverage requirements for various risk categories
  • Risk transfer strategies and contractual protections
• Prepare comprehensive Annual Risk Management Report detailing program status, outcomes, and recommendations for Board of Directors and executive management
• Conduct quarterly risk assessments with documented follow-up actions and outcome tracking
• Assist the Patient Safety and Quality Management Committee in investigating and analysis of adverse events, sentinel events, and near-miss incidents to identify root causes and systemic issues
• Participate in implementation and oversight of the Corporate Compliance Program

 FTCA Risk Management and Training Program Administration

• Develop and administer comprehensive annual risk management training plan aligned with FTCA requirements
• Ensure 100% compliance with mandatory training requirements for all staff: 
  • HIPAA privacy and security regulations
  • Medical record confidentiality and documentation standards
  • Universal precautions and infection prevention protocols (including bloodborne pathogens, hand hygiene, care of the pregnant patient, and personal protective equipment)
  • Event reporting systems and culture of safety principles
• Coordinate specialized training for clinical staff based on service lines through work with our Site Nurse Managers and other members of leadership: 
  • Equipment sterilization and maintenance procedures
  • Referral tracking and closed-loop communication systems
  • Diagnostic test result management and follow-up protocols
  • Hospital admission and discharge coordination
• Coordinate service-specific risk management training programs, in collaboration with Department leads: 
  • Medical Practice: Prenatal/postpartum care standards, maternal health screening, substance use disorder identification, intimate partner violence assessment
  • Dental Services: Infection control for aerosol-generating procedures, dental equipment sterilization, medical emergency management, informed consent processes
  • Behavioral Health: Screening and assessment tools, patient communication strategies, opioid risk management, medication-assisted treatment protocols, suicide risk assessment
• Utilize multiple data sources to identify training priorities: 
  • Incident reports and root cause analyses
  • Malpractice claims and litigation trends
  • Patient grievances and satisfaction surveys
  • Culture of safety assessments
  • Quality measure performance data
  • State licensure and regulatory findings
  • FTCA site visit feedback and recommendations
• Implement robust training tracking and accountability systems: 
  • Maintain centralized training completion database
  • Generate monthly compliance reports for department managers
  • Develop remediation protocols for non-compliant staff
  • Report quarterly training metrics to Board Quality Committee
• Coordinate with Human Resources to integrate risk management training into: 
  • New employee orientation 
  • Annual competency assessments
  • Privileging and credentialing processes

 Data Management and Reporting

• WRH has an analytics group that performs measuring and report creation and production
• Maintain strict confidentiality of all patient health information in accordance with HIPAA regulations
• Generate data-driven reports for internal and external stakeholders
• Develop dashboards and visualization tools to communicate risk and quality metrics
• Ensure data integrity and accuracy across all reporting platforms

 Organizational Leadership

• Foster culture of continuous quality improvement and patient safety
• Serve as subject matter expert on risk management and patient safety initiatives
• Collaborate with interdisciplinary teams to implement evidence-based practices
• Enliven and support the mission, vision, and values of Wood River Health
• Adhere to organizational policies, procedures, and Compliance Program Standards
• Performing additional duties as assigned to meet organizational needs

EDUCATION AND EXPERIENCE: 

• Bachelor of Science in Nursing or related healthcare field
• Minimum three years of progressive experience in nursing, healthcare compliance, and/or risk management
• Experience with Electronic Medical Records systems, preferred
• Community health center or FQHC experience, preferred
• Exceptional interpersonal and communication skills with ability to influence without authority
• Strong analytical and problem-solving capabilities
• Ability to manage multiple complex projects simultaneously
• Ability to effectively use MS Office Suite, Internet, email, database management, and healthcare information systems
• Cultural sensitivity necessary to work with a diverse patient and staff population
• Commitment to removing systemic barriers to care rather than attributing failures to patients

LICENSURE AND CERTIFICATION:

• Current, unrestricted Registered Nurse (RN) license in Rhode Island
• Current BLS certification
• Certification in Healthcare Risk Management (CPHRM) or Healthcare Quality (CPHQ), preferred
• Additional certifications in risk management, quality improvement, or patient safety, preferred

Wood River Health is an Equal Opportunity Employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, sexual orientation and gender identity), national origin, age, disability, genetic information, protected veteran status, or any other characteristic protected by federal law.