Regulatory Quality RN Clinical Care-Intermediate
Company: Presbyterian Healthcare Services
Location: Sun City
Posted on: April 1, 2026
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Job Description:
Location Address: 9521 San Mateo NE Albuquerque, NM 87113-2237
Compensation Pay Range: Minimum Offer $58,073.60 Maximum Offer
$88,670.40 Summary: Build your Career. Make a Difference.
Presbyterian is hiring a skilled Regulatory Quality RN Clinical
Care-Intermediate How you grow, learn and thrive matters here. •
Educational and career development options, including tuition and
certification reimbursement, scholarship opportunities • Staff
Safety (a wearable badge that allows nurses to quickly and
discreetly call for help when safety is a concern) • Differentials
for night/weekend shifts, higher education, certifications and
various lead roles (for eligible positions) • Malpractice liability
insurance • Loan forgiveness through the New Mexico Higher
Education Department • EPIC electronic charting system Type of
Opportunity: Full time FTE: 1.00 Job Exempt: Yes Work Shift: Days
(United States of America) Responsibilities: Presbyterian is
seeking a Regulatory Quality RN Clinical Care-Intermediate
Responsible for PH Quality of Clinical Care (QOCC) activities.
Investigates complaints alleging inappropriate Physical Health (PH)
clinical care or alleged inappropriate behavior by a physician or
other health care practitioner/provider. Applies the knowledge of a
registered nurse to determine the key factors in each case and
whether the standard of care has been met, documenting and
summarizing findings for all parties regarding investigative
findings. Collaborates on quality of clinical care work with PHP
Business Partners including Medical Directors, Provider Network
Operations, Credentialing, Care Coordination, Critical Incidents
Team, and Legal counsel. Assists the provider peer review process
which assesses and reviews the quality of patient and member care
provided by practitioners and facilities. Some key responsibilities
include: With guidance, reviews, responds to, and researches
complaints related to quality of medical care utilizing a high
level of knowledge and skill in nursing practice in order to
discern the key factors in each case to ensure that all quality of
care issues are identified and addressed. Provides referrals, as
appropriate to the case, to correlating PHP entities including but
not limited to: Legal, Risk Management, Behavioral Health QOCC
Team, Provider Network Operations, Credentialing, Critical
Incidents Teams, or Care Coordination. Perform Physical Health QOCC
Case Management-all levels Conduct Practice Pattern Reviews Manage
PIPs (Performance Improvement Plan) Conducts Medical Record Review
(MRR) Prepare and Present Medical Director Reviews Attend Weekly
Medical Records Huddle Writes QOCC Correspondence/Letters With
guidance, writes and presents QOCC case summaries to PHP's Physical
Health Professional Practice Evaluation Committee (PH PPEC). With
guidance, manages and communicates PH PPEC recommendations
including but not limited to: Practice Pattern Reviews, Performance
Improvement Plans, and/or Recommendations for Terminations,
Suspensions, or Admissions Holds. Other duties as assigned.
Qualifications: Bachelors in Nursing Five years hospital nursing
experience Current NM RN License Skills in Outlook, Word, Excel,
and Power Point Proficiency in writing or professional
correspondence Preferred: Critical Care experience Complaint
Management experience Quality Improvement experience Care
Coordination/Case Management experience We're all about well-being,
starting with yours. Presbyterian employees have access to a fun,
engaging and unique wellness program, including free on-site and
community-based gyms, nutrition coaching and classes, mindfulness
and meditation resources, wellness challenges and more. Learn more
about our employee benefits. 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.
Compensation Disclaimer The compensation range for this role takes
into account a wide range of factors, including but not limited to
experience and training, internal equity, and other business and
organizational needs. We're Determined to Support New Mexico's
Well-Being | Presbyterian Healthcare Services
Keywords: Presbyterian Healthcare Services, Sun City West , Regulatory Quality RN Clinical Care-Intermediate, Healthcare , Sun City, Arizona
