RN Inpatient Quality Program Manager

A company is looking for an Inpatient Quality Program Manager.

Key Responsibilities

Lead new hire onboarding and development, ensuring standardized training and assessment of learning milestones

Monitor and improve operational compliance, partnering with leadership to track timeliness and accuracy

Drive clinical decision quality through audits and interventions, while integrating CMS regulatory updates into practices

Required Qualifications

Unrestricted RN license with 5+ years of nursing experience, including at least 4 years in health plan Utilization Management

Demonstrated leadership and coaching abilities, with experience training nurses / clinicians in complex topics

In-depth knowledge of Medicare Advantage, CMS guidelines, and regulations governing claims and appeals

Experience with AI / LLM technologies applied to clinical decision-making and operational workflows

Member- and colleague-centric mindset, demonstrating empathy and commitment to high-quality care delivery