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.