Telecommute RN Clinical Quality/Compliance Admin
Health Plan Provider based in North/Central West Virginia is seeking an RN for the position of a Quality/Compliance Administrator. Initial training period located in Charleston, West Virginia and hotel lodging is provided.
Responsibilities:- Conduct site visits with new health plan of WV Providers/Physicians and follow-up of Medical Record Review for existing Providers.
- Participate in Quality Management (QM) by coordinating activities related to compliance and accreditation for Company
- Develop and maintain pertinent compliance plans
- Monitor adherence to plans and prepares status reports
- Conduct audits: Identify training/communication needs and implement related programs to address needs.
- Ensures that all policies and procedures are updated as legislation or accreditation standards change
- Implement standardization of procedures and documentation within Company
- Develop and deliver executive level presentations
- Represent senior management as needed on compliance issues and related committees
- 75% travel through North/Central West Virginia
- BA/BS + 5 years compliance, audit or quality improvement experience; or any equivalent combination of education and experience
- Experience with regulatory/accreditation audits and knowledge of regulatory/accreditation standards in a health or managed care environment
- Ability to travel overnight (will be compensated for mileage and other travel related expenses)
- Demonstrated ability to work independently, prioritize workload with strong communication skills
- Strong PC skills in MS based applications (including Word and Excel)
- Project Management experience is a plus
- Prior experience with Quality Initiatives, HEDIS, and Site Visit Review are pluses!
Location: North/Central West Virginia/Telecommute
Compensation: TBD
Posted: Friday, July 3, 2009
Employer Posted:Thursday, July 02, 2009
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