RN Quality Assurance (Healthcare)

Tech Tammina LLC RN Quality Assurance (Healthcare) Syracuse, NY Job type -Temp to Hire: pay range for this position is $25 - $41/hr. Job Description :- Serving in a clinical capacity, this individual will accurately and  efficiently conduct medical reviews, including but not limited to  HEDIS/Quality Assurance Reporting Requirements (QARR), DOH  requests, prenatal and postpartum reporting and ad hoc requests  from Medical Directors. The QA Nurse will also participate in the  Quality Management program by identifying improvement  opportunities, development of barrier analysis and assisting in  development of interventions to improve outcomes.  Conducts retrospective multiple medical record reviews to retrieve  data for internal and external quality measures for HEDIS and QARR  Abstracts data from medical records, uses portable scanner to  retrieve relevant components of medical record (20%)  Responsible for the integrity of the data that is collected.  Identify improvement opportunities, conduct barrier analysis review,  and develop interventions to address identified barriers (20%)  Conduct telephonic outreach to members needing services identified  Telephonic outreach to Educate Providers on measures Identified on  Complies with all guidelines established by the Centers for Medicare  and Medicaid (CMS) and guidelines set forth by other regulatory  agencies, where applicable, and defined in the Universal American  And all other duties assigned by the manager and/or supervisor  Professional verbal and written communication skills, with the ability  Organizational skills with the ability to handle multiple tasks and/or  Time management skills with the ability to prioritize and schedule  daily activities for the most efficient use of time Problem solving skills with the ability to look for root causes and  Must have a track record of producing work that is highly accurate,  demonstrates attention to detail, and reflects well on the  Responsibilities:  reporting. (20%)  on the Quality Workplan (20%)  the Quality work plan (20%)  Corporate and department policies. Required Skills:  to clearly articulate thoughts and ideas projects at one time  implementable, workable solutions  organization  Required Experience:  Undergraduate degree or equivalent experience  2 or more years of managed care experience  Current, unrestricted RN license in NY  Knowledge of ICD coding helpful Quality Management, Case Management or Utilization Management  Personal computer experience should include working with Microsoft  Word, Excel, PowerPoint and Outlook at the intermediate level at a  Universal American Corp. is an Equal Opportunity / Affirmative  experience preferred  minimum  RN Quality Assurance (Healthcare) Syracuse, NY  Action Employer and does not discriminate because of age, color,  disability, ethnicity, marital or family status, national origin, race,  religion, sex, sexual orientation, military veteran status, or any other  characteristic protected by law. We are committed to attracting,  retaining and maximizing the performance of a diverse and inclusive  workforce.  Work Environment / Physical Demands:  Work is performed in a professional office setting, business casual  dress environment. Working extended hours may be required as  The physical demands for this position include exerting up to 10  pounds of force occasionally, and/or a negligible amount of force  frequently to lift, carry, push, pull or otherwise move objects,  including the human body. This is considered sedentary work, which  involves sitting most of the time; walking and standing are required,  as well on occasion. Telephone work and/or computer work are  typically required. Reasonable accommodations may be made to  enable individuals with disabilities to perform the essential functions.  needed. Share the Profiles to paramesh(at)tammina(dot)com Contact: 703-349-2332 Keep the subject line with Job Title and Location