Quality Management Nurse - RN, East Tennessee, Chattanooga

Utilize Health

Utilize Health

Quality Assurance

Chattanooga, TN, USA

Posted on May 17, 2026
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Position: Quality Management Nurse –RN, East Tennessee, Chattanooga

Hours: Salaried

Reports to: VP, Clinical Operations

Location: Hybrid (Must be located in Greater Chattanooga Area)

This position oversees the quality of care for members in East Tennessee.

ABOUT US

Utilize Health is a care management company whose mission is to improve the health and well-being of people with neurological conditions. Our specialized care management program offers a better way to manage brain injury, stroke, spinal cord injury, and other neurological diagnoses allowing for better continuity of care and reduction of avoidable high-cost services. Utilize Health's Care Managers and Nurses support members as an advocate through their healthcare journey, assisting them with physical, behavioral, functional, preventative and social determinants of health needs.

JOB OVERVIEW

The Quality Management Nurse (RN) is responsible for ensuring quality throughout the Utilize Health patient journey. The Quality Management Nurse serves as the clinical quality expert for a designated pod of care managers, ensuring high-quality, coordinated care for members with neurological conditions. The RN monitors pod-level quality metrics, responds to clinical escalations, reviews and optimizes care plans, and coaches care managers to meet quality standards and patient outcome goals. The Quality Management Nurse is responsible for monitoring and intervening to meet patient care measures including gaps in care, hospitalizations, and other clinical indicators aimed at improving health. The Quality Management Nurse responds to clinical escalations from the care management team, creates and reviews comprehensive care plans, and overcomes barriers to care. The Quality Management RN assumes responsibility for assisting patients with navigating the healthcare system, providing patient and family education that supports self-management and reduces complications & sequelae, and interventions that address social determinates of health. The Quality Management Nurse acts as a patient advocate in supporting factors that impact customer satisfaction and overall health outcomes.

This position is hybrid with work from home and within the community (community visits with high acuity members or those with enhanced support needs). Occasional travel to corporate office in Nashville, TN is required.

JOB RESPONSIBILITIES

Quality

  • Improve outcomes by reducing hospital and emergency room admission, closing gaps in care, and actively coordinating care of individuals with a neurological condition.
  • Develops program content, training documents, operating procedures and guidelines to support quality and clinical excellence.
  • Accurately tracks quality measures and intervenes when there is an opportunity to improve.
  • Provides clinical expertise in care team huddles, clinical case reviews, triages and warm handoffs.
  • Assists in transitions of care from hospital, acute rehab, or other inpatient care settings to home.
  • Ensure timely and appropriate documentation in the Electronic Health Record.
  • Participate in identification & enrollment of appropriate patients.
  • Provides in-home care coordination visits for high acuity members or those with enhanced support needs.
  • Monitors pod-level quality and utilization metrics (readmissions, ED visits, gaps in care) and partners with care managers to implement targeted interventions.
  • Ensures adherence to Utilize Health clinical protocols, documentation standards, and quality benchmarks within the assigned pod; escalates trends and risks to leadership.
  • Provides real-time support to care managers, including guidance on care coordination triage, escalation and risk management.

Care Coordination

  • Provide care coordination, health promotion, care planning and transitional care activities.
  • Coordinate care and manage quality measures ensuring Utilize Health program goals are met.
  • Perform care coordination activities to include continual assessments of patients’ physical and behavioral health needs, interventions, patient education and development of an individualized care plan with measurable goals that ensure needs are met.
  • Ensure patient’s daily medical, behavioral, and environmental needs are planned for and coordinated.
  • Demonstrate knowledge of community and care resources.
  • Support patient access to care by serving as a liaison between the patient and care providers such as PCPs and specialists and health plan(s).

Training & Education

  • Member of the Utilize Health multidisciplinary care coordination team, serving as a quality advocate, educator and trainer.
  • Training and educating care management team to meet quality goals.
  • Assists in the development and dissemination of patient education including patient action plans, care plans and clinical content.
  • Provides ongoing 1:1 and group coaching to care managers on professional reasoning, documentation quality, and care coordination best practice.
  • Mentor new employees.

OTHER RESPONSIBILITIES:

  • Must maintain an active Tennessee Registered Nurse License.
  • Responsible for attending all in-services, continuing education and annual health requirements.
  • Comply with all OSHA and safety policies, practices, and procedures. Report all unsafe practices or accidents to supervisor.
  • Will be compliant with the relevant regulations concerning the privacy and security of patient’s protected health information (PHI) as established by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
  • Perform other duties as assigned.

KEY COMPETENCIES:

  • Clinical judgement, quality improvement and data interpretation, coaching and education, collaboration, problem-solving, and patient advocacy.

MINIMUM QUALIFICATIONS:

  • Graduated from an accredited Registered Nurse Program.
  • Compact or State of Tennessee Active Registered Nurse Licensure.
  • American Heart Association’s BLS certification for HealthCare Providers Required upon hire.
  • Two years of experience in clinical quality preferred. Case management or home health experience preferred.
  • Neurological care experience.
  • Ability to travel
  • Passion for working with the neurological & underserved populations.
  • Demonstrated ability to provide care coordination.
  • Proficient in documenting care coordination activities in an electronic medical record.
  • Excellent oral and written communication skills.
  • Proficient in Microsoft Office Suite.

APPLY

To apply, send a cover letter and resume to careers@utilizehealth.com.

Pre-employment screening required including background check and drug screening test. Utilize Health is a proud Equal Employment Opportunity employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

Benefits:

  • 401(k)
  • 401(k) matching
  • Health insurance
  • Health savings account
  • Paid time off
  • Vision insurance
Apply now
See more open positions at Utilize Health