The Quality Review Nurse provides clinical leadership to enhance patient care and safety by monitoring healthcare processes, auditing clinical data, and implementing evidence-based improvements. This role focuses on improving clinical workflows, ensuring compliance with regulatory standards, and closing care gaps for patients within the community. This role requires a strong clinical background (RN required), deep knowledge of healthcare regulatory and accreditation compliance, and the ability to lead cross-functional initiatives across clinical operations, field staff, and leadership teams.
Clinical Operations- Develop, maintain, and standardize clinical policies and procedures, ensuring documents remain current and centrally managed
- Review and revise policies and procedures in response to regulatory changes, operational needs, and industry best practices.
- Support the development and implementation of standardized clinical workflows that promote consistency and efficiency across communities.
- Partner with leaders to support the implementation of electronic health records (EHR) and ongoing utilization.
- Identify opportunities to improve clinical processes, documentation, and operational efficiency across programs.
- Collaborate with community leadership on clinical initiatives that enhance resident care and organizational effectiveness.
Leadership Development and Education- Oversee the development and delivery of clinical, regulatory, and leadership education.
- Ensure all employees maintain required credentials, licensure, and annual training.
- Ensure competency assessments and in-service education align with clinical and compliance standards.
- Support onboarding, development, and mentoring of Directors of Nursing and other clinical leaders.
- Promote a culture of learning, accountability, and continuous improvement/
Risk Management and Incident Oversight- Lead incident review, reporting, and investigation processes in accordance with Massachusetts Adult Foster Care and Group Adult Foster Care regulations.
- Collaborate with leadership on corrective action plans and communication protocols.
- Develop proactive risk management strategies to ensure participant and resident safety.
- Monitor incident trends and collaborate with community leadership to identify opportunities to reduce clinical risk and improve resident safety.
Collaboration & Communication- Identifies and executes needed collaborations to enhance communities' service provision with regional and corporate operations teams.
- Ensures residents and families are educated about residents' rights.
- Creates and maintains a warm professional environment.
- Assures that all associates are fully informed on the answers to the most frequently asked questions by residents, families, and prospective families.
- Facilitates regularly scheduled meetings with department heads and associates.
- Possesses excellent communication skills, both verbal and written, and the ability to relate in a positive and professional way to a diverse resident and associate population.
What we are looking for:- Please note this position is primarily an in-office position that may require occasional travel to the field to review care team education or caregiver/client education
- Willingness to travel within assigned region required.
- Valid driver's license and reliable transportation required.
- Licensed as an RN by Massachusetts Board of Registration in Nursing, required.
- Minimum of two-year recent experience in the direct care of elders or adults with disabilities.
- Fluency in both English and second language strongly preferred.
- Case management, behavioral health, social services and/or community health worker experience preferred.
- Strong communication, documentation and organizational skills required.
- Must be solution oriented and able to multitask.
- Office-based work in a clean well-lit environment with fluctuating temperatures near others.
- Client-facing field staff and community liaisons require frequent travel to client homes or community settings; ability to drive safely; work in client homes may involve varying temperatures, odors, allergens, pets, and other environmental factors.
- Requires substantial periods of repetitive work utilizing a computer, monitor, keyboard, and mouse.
- Requires lifting and carrying equipment and supplies weighing up to 35 pounds; requires pushing and pulling equipment and supplies weighing up to 35 pounds; requires walking and standing; requires frequent sitting more than 75% of the workday; requires the ability to negotiate stairs; requires visual acuity and manual dexterity to operate equipment.
- Employer sponsored health Insurance with a generous employer match.
- Dental and Vision Benefits.
- Supplemental Benefits
- Life, Accident, Critical Illness and Disability Insurance.
- 401K with a 5% company match.
- Accrued Paid-Time-Off.
- Ten company paid holidays.
- Wellness Benefits.
- Tuition Reimbursement.
- Supportive team structure and company culture with a focus on work/life balance.
