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Quality Management Supervisor Job Details

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Company:  Nurse Resolutions
Job Code:  771-50591
Categories:  Skilled Nursing / Nursing Home (SNF)
Region/Province:  California (CA)
Job Description: 

Job Purpose:

Working supervisor who processes Appeals, Grievances and Potential Quality Issues as well as supervises the Grievance and Appeals Unit staff, functional activities and workflows, daily operations.  Is responsible for compliance with regulations and internal standards.  Facilitates assigned QI Committees.  Collect, analyze and report data.  QM operations are 7 days per week.

 

Job Results:

Meets compliance with CMS & DHCS regulations and internal standards.  Meets compliance with internal productivity and quality standards.  Policies and procedures and desktop procedures are written and current.  Assigned committees are conducted.  Reports are presented timely and accurately to Committee and department heads.

 

·         RN license in CA. Current and in good standing.

·         Degree related in health care field preferred

·         Minimum 5 years clinical experience

·         Minimum 3 years experience in Grievance & Appeals review, Quality, Utilization, Case Management or Risk Management

·         Minimum 3 years experience in Managed Care

·         Excellent critical thinking skills

·         Proficient skills in keyboard, MS Word and Excel

 

Abe Ghebrehiwet
Senior Account Executive
Nurse Resolutions
888.411.2228. Toll Free
407.341.9647. Cell
407.557.2270. Fax
www.NurseResolutions.com
Abe@NurseResolutions.com


Post Date:  11/20/2010
 

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