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Medical Management Specialist - RN / Registered Nurse (8344)

Utilization Review Nurse | Albuquerque, NM | Contract

Job Description
Medical Management Specialist – RN / Registered Nurse
Work Location: Albuquerque, NM

InGenesis is currently seeking a Registered Nurse / RN to work as a Medical Management Specialist for our client located in Albuquerque, NM. In this role, you will perform ongoing monitoring of critical incidents and quality of care to ensure compliance with accreditation and regulatory requirements.

If you meet the qualifications outlined below, apply today and we’ll reach out to answer any questions you may have!

Job Duties/Responsibilities
• Perform on-site medical record reviews to evaluate delivery of care.
• Facilitate assigned quality improvement projects.
• Plan and monitor options to meet project objectives.
• Address issues related to clinical quality improvement projects.
• Coordinate internal support functions for assigned projects.
• Evaluate effectiveness of projects and identify opportunities for improvement.
• Function as preceptor for orientation of new employees.
• Provide interface regarding existing/proposed clinical quality improvement initiatives.
• Attend internal/external meetings to keep apprised of quality improvement and managed care issues/information.
• Perform other duties as assigned.

Minimum Qualifications
• Current Registered Nurse / RN, Licensed Practical Nurse / LPN, or Respiratory Therapist, or other medical specialty with unrestricted license in state of work.
• 3+ years of clinical practice experience.
• 2+ years of utilization management, case management, quality improvement, or project management experience.
• Experience conducting presentations for member/provider training.
• Current driver’s license, reliable transportation, and applicable state insurance.
• Ability to travel including overnight stays.
• Effective communication skills (verbal/written).
• PC proficiency.
• Data analysis experience.