New Jersey Licensed Quality Assurance Specialist

Job Summary

A company is looking for a MLTSS Quality Assurance Specialist responsible for reviewing assessment and quality oversight activities for the MLTSS/DSNP Quality Assurance program.

Key Responsibilities:

• Conduct audits on member charts and assess compliance with regulatory requirements
• Analyze and distribute audit reports, including error trends, for management follow-up
• Collaborate with the MLTSS/DSNP Department to develop process improvement recommendations

Required Qualifications, Training, and Education:

• Bachelor's degree preferred, or LPN with 5 years of Clinical Case Management experience
• Minimum of 3 years experience in the health care delivery system/industry
• Experience in chart reviews and familiarity with regulatory agency standards
• Quality initiative experience is required
• Preferred Licensed Registered Nurse