Clinical Quality RN - CT Licensed
Company: VirtualVocations
Location: Fontana
Posted on: October 30, 2024
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Job Description:
A company is looking for a Remote Clinical Quality Care RN.
Key Responsibilities
Evaluate medical management case work to determine compliance with
medical necessity criteria
Verify adherence to regulatory guidelines in clinical case reviews
and care planning processes
Identify and report quality of care concerns and inconsistencies in
case reviews
Required Qualifications
Unrestricted current RN licensure in state of residence
2+ years of experience in clinical case review or chart auditing
using CMS, MCG, NCQA criteria
2+ years of experience in medical management while working in a
remote setting
Experience operating within multiple platforms that house case
documentation and clinical records
Bachelor of Science in Nursing preferred
Keywords: VirtualVocations, La Quinta , Clinical Quality RN - CT Licensed, Healthcare , Fontana, California
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