Travel 25 % of the Time. 3 years of experience as Case Manager. Active Unrestricted RN License for your state of residence. 2 years' of clinical management experience overseeing a staff of 10 or more. Efficiently navigate Microsoft Office. Dataentry experience into case management systems.
Completing facility surveys and enters the data into a main data base. Addressing issues regarding the facilities or our members. Assessing the facility using established guidelines. Qualifications for this position include: Ability to travel 50% of the time.
Must be able to: Develop and implement quality improvement interventions. Resolve deficiencies impacting plan compliance. Perform data analytic and reporting activities. Required Skills: High School or GED. Current unrestricted RN license. 2+ years of experience in Quality Improvement.
Candidates will be responsible for the following: Performing charge audits reviews by verifying billing data. Identifying charging, coding, or clinical documentation issues. Analyzing and resolving specific billing edits that require an RNs clinical expertise. Skills and Requirements Include:
Coordinating and performing on-site data collection and dataentry. HEDIS chart abstracting, data collecting and related activities. Accurately reviewing medical records/charts collected from provider offices. Applicants must meet the following qualifications: Ability to travel as needed.
Performing data collection, data collection, and data review from electronic medical record and chart review. Reviewing data to ensure compliance to performance measures. Must meet the following requirements for consideration: Must be a certified RN with an active NC license.
Assisting in medical chart review and data collection during HEDIS season. Skills and Requirements Include: Support Retail Center quality events and participate in meetings with concurrent review nurses, etc. Bachelor's degree or equivalent work experience Nursing, Healthcare, Business.