Quality Review Specialist ( RN )

Confidential Company  •  Brooklyn, NY

Less than 5 years experience  •  Professional, Scientific & Technical Services

$80K - $100K
Posted on 04/20/18
Confidential Company
Brooklyn, NY
Less than 5 years experience
Professional, Scientific & Technical Services
$80K - $100K
Posted on 04/20/18

JOB DESCRIPTION

The Quality Review Specialist (RN) will: 

  • Ensure compliance with NYS DOH and CMS regulations through development of auditing tools, specifically validating all data collected
  • Analyze collected audit data, identify trends for staff re-training, and implement corrective action plans in collaboration with Clinical Management staff
  • Provide support to Directors, Managers and Supervisors to insure that all documentation and reporting requirements are prepared and maintained in a professional and well-coordinated manner
  • Review, collect, and prepare evidence packets for all scheduled Fair Hearings

REQUIRED SKILLS

  • 2+ years of Care Management experience
  • Associate's Degree in Nursing
  • NYS Registered Nurse (RN) license
  • Knowledge of Medicare and Medicaid regulations
  • Working knowledge of Audit techniques and methodologies
  • Working knowledge of State and Federal regulations
  • Solid assessment, clinical, and documentation skills
  • Patient oriented
  • Great interpersonal skills
  • Excellent communication skills (written and verbal)
  • Strong attention to detail
  • Highly organized
  • Able to multitask efficiently and effectively

Desired Skills

  • Bachelor's Degree in Nursing

J143149

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