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Nurse Quality Management Specialist

Health Care | Richardson, TX | Temp to Perm

Job Description

Nurse Quality Management Specialist

InGenesis has an exciting opportunity for a Nurse Quality Management Specialist to work in Richardson, Texas.  This is an exciting opportunity to work for a well know insurance company

Essential Functions:

Perform on-site medical record reviews to evaluate delivery of care in relation to Enterprise clinical practice guidelines.

Responsible for facilitating and monitoring of assigned quality improvement projects, including the following:

  • Consult with network physicians, Medical Group/IPAs, providers, members, and other resources, as appropriate, to assess, plan, facilitate implement, coordinate, monitor and evaluate options to meet clinical quality improvement project objectives and to promote high quality and cost effective outcomes.
  • Gather information, analyzes and communicates it, and develops recommendations regarding clinical quality improvement projects.
  • Assist in addressing issues related to clinical quality improvement projects for the managed care programs to assure compliance with contractual arrangements, accreditation requirements, government regulations and employer group expectations

Job Requirements 

  • Active and unrestricted license either Registered Nurse (RN) or Licensed Practical Nurse (LPN)
  • 3 years clinical practice experience.
  • 2 years UM, Case Management, quality improvement and/or project management experience.
  • Experience conducting presentations for member and/or provider training.
  • Current Illinois driver's license.
  • Ability to travel including overnight stays.
  • Verbal and written communications skills.
  • Data analysis experience.
  • PC proficiency to include Word, Excel, and PowerPoint.

 

 

Key Words: Registered Nurse, RN, LPN, Licensed Practical Nurse, Licensed Vocational Nurse, Quality Improvement, Quality Assurance, Chart, Audit, HEDIS