- Naven Health (Nashville, TN)
- …**Preferred Qualifications & Interests (PQIs)** + Previous experience as a Quality Assurance Nurse or Chart Review Auditor + Knowledge and understanding ... teammates, and the patients we serve. **Job Description Summary:** The Quality Assurance Chart Review Nurse is responsible for the review of assigned… more
- Help at Home (Bloomington, IN)
- …Conducts quarterly audits for branch. + Conducts random OASIS form audits. + Conducts RC review for staff with poor quality scores. + Serves as backup when staff ... Help at Home is the nation's leading provider of high- quality care and support solutions.Our goal is to enable the highest level of personal independence and… more
- Sunnyside Nursing and Post-Acute Care (Torrance, CA)
- …necessary criteria and compliant with the regulatory guidance + Management of (QASP) quality assurance surveillance plan - review the facility's performance ... + Monitoring State and regulatory survey compliance. + Investigating Quality Assurance issues related to grievances coming...with MDS coordinator improvement action and monitoring plan + Review monthly or as needed facility's quality … more
- National Health Care Associates (Melville, NY)
- …you to join our team! **-** **What You'll Do:** As theRisk Manager & Quality Assurance Coordinator(RN),you'll play a vital leadership role in upholding the ... health, dignity, and well-being at the center of everything you do. + Review clinical documentation and care processes to ensure that residents receive appropriate,… more
- Koniag Government Services (Dock Junction, GA)
- …levels to the Clinic Nurse Manager + Participate in Quality Assurance activities, data analysis and review to make improvements within clinic operations. ... Koniag Government Services company **,** is seeking a Registered Nurse - Part- Time to support **KOS** and our government...+ Report site-specific problems to the Clinic Nurse Manager (eg, staffing difficulties, supply issues, environment of… more
- University of Michigan (Ann Arbor, MI)
- …+ Board all add-on/trauma/urgent cases + Coordinate communication hand-off to Midnight Charge Nurse Quality Assurance and Research + Assists in the ... collaboration, and peer review are exercised + Plan, coordinate and evaluate quality assurance activities + Participate in the development of patient care… more
- AmeriHealth Caritas (Philadelphia, PA)
- …comply with federal, state, and local regulations, such as the National Committee Quality Assurance (NCQA) standards related to appeal and grievance operations ... **Role Overview: ;** The Clinical Appeals Reviewer is responsible for processing appeals and ensuring all milestones are met in compliance with regulatory… more
- Zelis (NJ)
- …is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings ... specific coverage policies. What you'll do: + Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of the DRG billed,… more
- PruittHealth (Norcross, GA)
- **JOB PURPOSE:** Senior Nurse Consultant assumes responsibility for conducting quality assurance reviews in the assigned facilities. Senior Nurse ... of resident and facility information. 8. Able to assist in coordination of Quality Assessments and Assurance activities with Nursing Home Administrator and DON… more
- Emanate Health (Covina, CA)
- …and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and… more