Registered Nurse Quality Reviewer

Job Summary

A company is looking for a Quality Review Nurse.

Key Responsibilities

• Audit and track audit results, delivering training to correct deficiencies
• Conduct medically related audits and prepare reports reflecting national scores and trends
• Deliver training for new policies and assist in coordinating national quality initiatives

Required Qualifications, Training, and Education

• Bachelor's degree in Nursing (BSN) preferred
• RN license required
• Professional certification such as CCM or CDMS preferred
• Six years of related experience in telephonic case management or utilization review
• Thorough knowledge of Managed Care practices and auditing processes