Quality Critical Incident Coordinator

Location Address:

Compensation Pay Range:

Summary:

Responsibilities:

Critical Incident Reporting is a Contractual requirement within the State of New Mexico and Presbyterian Health Plan Medicaid Contract. Critical Incidents include but are not limited to reports of abuse, neglect, and exploitation towards a Member. This position is responsible for the coordination and processing of basic and specific incident types of incoming Critical Incident Reports. Ensures that the daily assignment of Critical Incidents are processed within the contractual timeline, and referred to the appropriate workflow to ensure the Members healthcare and safety needs are met. Also supports the team with initiatives and specialized program activities with moderate oversight and independent judgement.

Some key responsibilities include:

• Under the direct supervision of Critical Incident Management RN Supervisor, this position is responsible for Critical Incident Reporting (CIR) activities.
• Verifies accuracy of data entered into the Critical Incident Reporting Portal, corrects inaccuracies and updates the portal appropriately.
• Completes daily processing of specific types of Critical Incidents on the NM CIR Portal and refers all Critical Incidents for appropriate follow up activities with Care Coordination, Providers, and/or other quality workflows as needed.
• Documents all pertinent Critical Incident data and information in the PHP internal database.
• Collaborates with the CIR team in routine meetings to identify issues, trends, best practices, and process improvement activities.
• Performs other duties as assigned.

Qualifications:

• Associates degree required.
• Three years of experience in health care required in lieu of degree; relevant health plan experience preferred.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.