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).