TOC RN Lead

Job

Overview

The TOC Lead is responsible for reducing the hospitalization admissions for the plan and leading and overseeing a team of registered nurses (RNs) and clerical staff in ensuring the completion of all TRC quality measure activities.

Oversee the completion of all assigned TRC quality measure activities, adhering to established timelines and deadlines. Track progress towards quality measure goals and identify potential roadblocks. Maintain a comprehensive understanding of TRC's quality measure program and relevant regulatory requirements (e.g., CMS).

Prepare clear and concise reports on quality measure performance for internal and external stakeholders. Foster a collaborative and supportive work environment for the nursing team. Provide direct supervision and coaching to teams on TRC quality measure requirements and protocols.

Develop and implement training programs to educate the team on specific quality measures. Run care rounds with Care management to ensure proper handoff between the two teams. Come up with initiatives and creative ways to manage members conditions and ensure they don’t return to the hospital post admission.

Required Education, Experience, and Licenses

Experience with Managed care required. Experience with hospital discharge planning preferred. Registered Nurse (RN) license with a minimum of 5 years of experience in a clinical setting. Strong leadership and supervisory skills with the ability to motivate and guide a team. Excellent communication, interpersonal, and problem-solving skills. Working knowledge of relevant quality measure programs and regulatory requirements (preferred).