California Licensed Quality Assurance Nurse

Job Summary

A company is looking for a Clinical Quality Assurance Nurse Auditor.

Key Responsibilities

• Evaluate clinical information and write/review various reports including Medical Record Reviews and Provider Bill Reviews
• Perform quality assurance reviews of peer review reports and ensure compliance with client specifications and regulatory standards
• Assist in resolving customer complaints and provide insights to management on consultant quality and compliance

Required Qualifications

• Bachelor's degree in nursing or related field, or a minimum of five years of related experience
• Registered Nursing license required
• Experience in case management and home health
• Strong knowledge of medical terminology, anatomy, and treatment protocols
• Proficiency in Microsoft Word, Outlook, and Excel