At Vantage Health Plan, we specialize in taking care of people: our members, our patients, and our employees. We offer competitive salaries and great benefits! Benefits include: Health, Dental, Life, Accidental Death and Dismemberment, Long Term Disability, Paid Time Off, and 401(k).
Vantage is currently looking for a Quality Improvement RN to work at our downtown Monroe location from 8:00AM – 5:00PM, Monday through Friday.
Job Summary: The Quality Improvement Nurse (RN) will work to help improve the quality of care within Vantage Health Plan.
Essential Duties & Responsibilities:
- Perform chart reviews to find missing diagnoses to ensure correct payment from the Centers for Medicare/Medicaid Services (CMS)
- Perform chart audits to ensure that the correct CPT/diagnoses have been submitted
- Identify and prioritize primary problems within physician offices
- Follow up with physicians on compliant patient care
- Review care plans for patients to ensure it complies with physician orders
- Maintain confidentiality regarding patient and business functions of the organization
- Promote favorable working conditions and relationships with administration, medical staff, consultants, other departments, patients, family members, volunteers, agencies, and any other individual or group affiliated with Vantage Health Plan
- Assist in training and continuing education of all providers and office staff to plan objectives, policies, and procedures
- Assist in continuously improving quality of care
- Assist in creating policies and procedures within the realm of quality of care
- Other duties as required
Knowledge, Skills, and Abilities:
- Graduate of an accredited school of Registered Nursing with a current license to practice as a RN in the State of Louisiana
- Ability to work with limited supervision and to make decisions based on established policies and procedures
- Exceptional interpersonal, verbal, and written communication skills
- Customer service oriented attitude/behavior
- Ability to work well in a team setting
- Works under general supervision of the Director of Quality Improvement
- Overtime may occasionally be required.
- Travel to physician offices will be required.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit, use hands and fingers, handle or feel, reach with hands and arms, and talk or hear. The employee is frequently required to stand and walk. The employee must regularly lift and/or move up to 10 pounds and frequently lift and/or move up to 40 pounds.