Registered Nurse Quality Assurance Specialist

Job Summary

A company is looking for a Utilization Review and Quality Assurance Specialist.

Key Responsibilities

• Evaluate clinical documentation and produce various medical reports
• Conduct quality assurance reviews to ensure compliance with standards and guidelines
• Provide training and feedback to enhance clinical review practices

Required Qualifications

• Degree in nursing or related field, or a minimum of five years of related experience
• Registered Nursing license or equivalent certification required
• Strong understanding of medical terminology, anatomy, and treatment protocols
• Experience in the insurance industry and/or utilization management preferred
• Proficient in Microsoft Office Suite and general office equipment