RN Quality Improvement & Metrics Manager

Job DetailsJob Location: Pittsburgh, PA 15218Position Type: Full TimePOSITION SUMMARY:   The RN Quality Improvement & Metrics Manager is responsible for leading the organization’s quality improvement, performance measurement, regulatory compliance, and population health initiatives. This role partners with clinical and operational leaders to improve patient outcomes, enhance access to care, optimize value-based reimbursement, and ensure compliance with Health Resources and Services Administration (HRSA) requirements and other regulatory standards.   The successful candidate will use clinical expertise, data analysis, evidence-based practice, and performance improvement methodologies to strengthen organizational quality programs and support the mission of providing high-quality, patient-centered care to medically underserved communities.   Mission Alignment The RN Quality Improvement & Metrics Manager is committed to advancing the mission of the health center by improving access, quality, equity, and patient outcomes for the communities we serve. This position promotes a culture of continuous improvement and supports the organization’s commitment to delivering high-quality, affordable, and patient-centered primary care. This version is aligned with HRSA expectations and reflects the responsibilities typically expected of an FQHC quality leader. It can also be further customized if your health center participates in specific programs such as Accountable Care Organizations (ACOs), Medicare Shared Savings Program (MSSP), or state Medicaid value-based payment initiatives.       ESSENTIAL FUNCTIONS:   Quality Improvement  Develop, implement, and evaluate organization-wide quality improvement initiatives.  Lead Performance Improvement (PI) projects using evidence-based methodologies.  Facilitate Plan-Do-Study-Act (PDSA) cycles and other quality improvement strategies.  In collaboration with the CMO, provide education and regular feedback related to quality metrics and provider performance.  Monitor outcomes and recommend system improvements that enhance patient care and operational efficiency.  Collaborate with HIPAA Compliance Manager to prepare board reports and meeting agendas    Quality Metrics & Performance Monitoring  Lead monitoring and reporting of key performance measures and others as defined by HRSA health standards:  Clinical Quality Measures (CQMs)  Preventive health screenings  Chronic disease management outcomes  Diabetes control  Hypertension control  Childhood and adult immunization rates  Women’s preventive health measures  Population health outcomes  Develop dashboards and scorecards that communicate organizational performance to providers, leadership, and governing boards.  Serve as a resource for evidence-based practice and clinical quality initiatives.    Regulatory Compliance  Ensure compliance with:  HRSA Health Center Program requirements  Uniform Data System (UDS) reporting  CMS quality reporting programs  HIPAA regulations  OSHA standards  State Department of Health regulations  Patient-Centered Medical Home (PCMH) standards, when applicable  Federal and state quality initiatives  Coordinate preparation for HRSA Operational Site Visits (OSVs), accreditation surveys, and external audits.    Population Health Management  Collaborate with clinical teams to improve health outcomes for high-risk and vulnerable patient populations by:  Identifying care gaps  Monitoring chronic disease registries  Improving preventive care compliance  Supporting care management initiatives  Evaluating social determinants of health data  Developing interventions that improve health equity    Data Analysis & Reporting  Analyze clinical, financial, and operational data to identify trends and opportunities for improvement.  Create meaningful dashboards using electronic health record data.  Present findings to executive leadership, Chief Medical Officer, Providers, and RN Administrator  Monitor provider quality performance and recommend improvement strategies.  Ensure accuracy of quality reporting submitted to HRSA and other regulatory agencies.    Education  Educate providers and staff on quality measures and performance expectations.  Develop training related to quality initiatives, clinical guidelines, and regulatory requirements.  Promote a culture of continuous quality improvement throughout the organizationQualificationsPOSITION REQUIREMENTS:   Education/Experience  Bachelor of Science in Nursing (BSN) required  Master’s degree in nursing, Public Health, Healthcare Administration, or related field preferred    Licensure  Current unrestricted Registered Nurse (RN) license    Skills/Abilities  Minimum five (5) years of nursing experience  Minimum three (3) years of experience in quality improvement, clinical quality, population health, regulatory compliance, or performance improvement  Experience within a Federally Qualified Health Center, community health center, primary care organization, or ambulatory care setting preferred  Experience with Value Based Care    Preferred Certifications  Certified Professional in Healthcare Quality (CPHQ)    Knowledge, Skills, and Abilities  Demonstrated knowledge of:  HRSA Health Center Program requirements  Uniform Data System (UDS)  Clinical Quality Measures (CQMs)  HEDIS  Value-Based Care  Population Health Management  Care Gap Closure  Chronic Disease Management  Evidence-Based Practice  Quality Improvement methodologies  Regulatory Compliance  Patient-Centered Medical Home (PCMH)  Health Equity initiatives  Social Determinants of Health (SDOH)  Ability to:  Interpret complex clinical data  Lead interdisciplinary quality initiatives  Develop executive-level reports and dashboards  Manage multiple priorities simultaneously  Communicate effectively with providers, leadership, and external stakeholders  Build collaborative relationships across departments    Technical Skills  Experience with:  Electronic Health Records (eClinicalWorks, Epic, Athenahealth, NextGen, or similar)  Microsoft Excel (advanced)  Microsoft Power BI or Tableau  Microsoft Office  Clinical reporting software  Population health management platforms  Quality reporting tools    Key Performance Indicators  Performance will be evaluated based on:  Achievement of UDS performance goals  Improvement in Clinical Quality Measures  Increased preventive screening rates  Improved chronic disease outcomes  Successful HRSA Operational Site Visits  Timely and accurate UDS reporting  Increased value-based reimbursement performance  Reduction in care gaps  Completion and effectiveness of quality improvement initiatives