As a Quality Review Auditor at MJHS, you will conduct audits to ensure the integrity of care management records. This role involves analyzing data to identify trends and implementing corrective actions, contributing to high-quality healthcare services for patients. Join us to make a meaningful impact in the healthcare sector.
Key Responsibilities
Conduct ongoing audits of care management staff
Ensure quality assurance and accuracy of care management records
Listen to calls by care management staff to assess professionalism
Develop audit tools and validate collected data
Analyze audit data to identify trends for staff re-training
Implement corrective action plans in collaboration with staff
Support Directors, Managers, and Supervisors with documentation and reporting
Required Qualifications
Graduate from an accredited School of Nursing
Minimum of two (2) years of working in care management experience
Licensed to practice as Registered Professional Nurse in NYS
Excellent analytical skills
Strong critical thinking skills
Knowledge of Medicare and Medicaid regulations
Ability to set priorities and to handle multiple assignments
Preferred Qualifications
BSN or BS degree
Managed Care experience
Working knowledge of audit techniques and methodologies
Working knowledge of State and Federal regulations