Quality Improvement Specialist (RN)

The Execu|Search Group
Aug 13, 2017
Aug 14, 2017
Employer Type
Direct Employer
Employment Type
Full Time
Job Description:

About the Opportunity A managed care company in New York City is actively seeking an experienced, licensed Registered Nurse (RN) for a promising Quality Improvement Specialist position with their growing medical staff. In this role, the Quality Improvement Specialist (RN) will be responsible for supporting the development and implementation of quality improvement interventions and auditing / assisting in resolving deficiencies impacting plan compliance to regulatory and accreditation standards. Apply today! Company Description Managed Care Company Job Description The Quality Improvement Specialist (RN) will: * Monitor quality improvement initiatives * Monitor and investigate all quality of care and collaborate with Medical Directors to determine impacts and next steps for actions * Analyze, update, and modify procedures and processes to continually improve QI operations * Collect and summarize performance data and identifies opportunities for improvement * Monitor and analyze outcomes to ensure goals, objectives, outcomes, accreditation, and regulatory requirements are met * Participate in site visit preparation and execution by regulatory and accreditation agencies * Conduct internal auditing of compliance with regulatory and accreditation standards * Assist in activities to prioritize clinical and service improvement initiatives * Participate in various QI committees and work groups convened to improve process and/or health outcomes * Investigate and incorporate national best practice interventions to affect greater rate increases * Handle other duties, as needed Required Skills * 3+ years of Managed Care experience; 2+ years of Quality Improvement experience * NYS Registered Nurse (RN) license * Acute Care and/or Case Management background * Previous experience with: Acute Care; Appeals; Chart / Concurrent Review; Denials; Discharge Planning; and, Enrollment * Computer savvy * Solid assessment, clincial, and documentation skills * Patient oriented * Great interpersonal skills * Excellent communication skilsl (written and verbal) * Strong attention to detail * Highly organized Desired Skills * Bachelor's Degree in Healthcare, Nursing, Health Administration, Public Health or related health field