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RN - Medical Management Accreditation & Audit Coordinator

RN - Medical Management Accreditation & Audit Coordinator

Job Description

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability, or protected veteran status.

This position is responsible for conducting audits as well as monitoring ongoing quality improvement activities within the Medical Management Program; analyzing compliance with departmental policies, regulatory and accrediting requirements, and preparing reports for management presentation to internal ancillary departments and committees; and serving as a resource to internal ancillary departments on quality and utilization issues and contributing to Accreditation Survey processes.

* Registered Nurse (RN), unrestricted license to practice in state of operations.
* 3 years medical/surgical or psychiatric nursing experience, including 2 years utilization review or case management capacity.
* Quality improvement experience.
* Working knowledge of the Medical Management Program and UM/CM policies and practices.
* Analytical skills.
* Verbal and written communication skills.
* PC experience utilizing Microsoft Office software.

Job Requirements

* Bachelor Degree in Nursing or Health Administration or in the healthcare field.
* Certified Professional Health Care Quality (CPHQ Certification).

Job Snapshot

Employment Type Full-Time
Job Type Nurse, Finance, Management, Accounting, Health Care
Education 4 Year Degree
Experience Not Specified
Manages Others Not Specified
Industry Insurance
Required Travel Not Specified
Job ID US-2022
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RN - Medical Management Accreditation & Audit Coordinator

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