RN Quality Assurance (Healthcare) at Tech Tammina in Syracuse, NY

Company Description

Tech Tammina LLC

Job Description

RN Quality Assurance (Healthcare) Syracuse, NY

Job type -Temp to Hire:

pay range for this position is $25 - $41/hr.

Job Description :-

Serving in a clinical capacity, this individual will accurately and

efficiently conduct medical reviews, including but not limited to

HEDIS/Quality Assurance Reporting Requirements (QARR), DOH

requests, prenatal and postpartum reporting and ad hoc requests

from Medical Directors. The QA Nurse will also participate in the

Quality Management program by identifying improvement

opportunities, development of barrier analysis and assisting in

development of interventions to improve outcomes.

Conducts retrospective multiple medical record reviews to retrieve

data for internal and external quality measures for HEDIS and QARR

Abstracts data from medical records, uses portable scanner to

retrieve relevant components of medical record (20%)

Responsible for the integrity of the data that is collected.

Identify improvement opportunities, conduct barrier analysis review,

and develop interventions to address identified barriers (20%)

Conduct telephonic outreach to members needing services identified

Telephonic outreach to Educate Providers on measures Identified on

Complies with all guidelines established by the Centers for Medicare

and Medicaid (CMS) and guidelines set forth by other regulatory

agencies, where applicable, and defined in the Universal American

And all other duties assigned by the manager and/or supervisor

Professional verbal and written communication skills, with the ability

Organizational skills with the ability to handle multiple tasks and/or

Time management skills with the ability to prioritize and schedule

daily activities for the most efficient use of time

Problem solving skills with the ability to look for root causes and

Must have a track record of producing work that is highly accurate,

demonstrates attention to detail, and reflects well on the

Responsibilities:

reporting. (20%)

on the Quality Workplan (20%)

the Quality work plan (20%)

Corporate and department policies.

Required Skills:

to clearly articulate thoughts and ideas

projects at one time

implementable, workable solutions

organization

Required Experience:

Undergraduate degree or equivalent experience

2 or more years of managed care experience

Current, unrestricted RN license in NY

Knowledge of ICD coding helpful

Quality Management, Case Management or Utilization Management

Personal computer experience should include working with Microsoft

Word, Excel, PowerPoint and Outlook at the intermediate level at a

Universal American Corp. is an Equal Opportunity / Affirmative

experience preferred

minimum

RN Quality Assurance (Healthcare) Syracuse, NY

Action Employer and does not discriminate because of age, color,

disability, ethnicity, marital or family status, national origin, race,

religion, sex, sexual orientation, military veteran status, or any other

characteristic protected by law. We are committed to attracting,

retaining and maximizing the performance of a diverse and inclusive

workforce.

Work Environment / Physical Demands:

Work is performed in a professional office setting, business casual

dress environment. Working extended hours may be required as

The physical demands for this position include exerting up to 10

pounds of force occasionally, and/or a negligible amount of force

frequently to lift, carry, push, pull or otherwise move objects,

including the human body. This is considered sedentary work, which

involves sitting most of the time; walking and standing are required,

as well on occasion. Telephone work and/or computer work are

typically required. Reasonable accommodations may be made to

enable individuals with disabilities to perform the essential functions.

needed.

Additional Information

Share the Profiles to paramesh(at)tammina(dot)com

Contact: 703-349-2332

Keep the subject line with Job Title and Location