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24 Quality Management Specialist jobs match your search criteria.

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Job Description: Quality Information Specialist Quality Information Specialist Location: Cocoa Beach, FL Salary:  Experience: 0.0 year(s) Job Type: Temporary / Consulting Job ID: U1015295       About the Opportunity An established managed care company located in Cocoa Beach, FL is actively seeking a diligent and patient-oriented Nurse to join their staff as a Quality Information Specialist. In this role, the Quality Information Specialist establishes and fosters a healthy working relationship between large physician practices, IPAs and the company. Apply today! Company Description Managed Care Company Job Description The Quality Information Specialist: Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Develops, enhances and maintains provider clinical relationship across product lines Leads and/or supports collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Captures concerns and issues in action plans as agreed upon by provider Documents action plans and details of visits and outcomes and reports critical incidents and information regarding quality of care issues Required Skills Bachelor's Degree in Nursing  or equivalent work experience of 3+ years directly related HEDIS record collection with analytical review/evaluation and/or Quality Improvement 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience Active Registered or Practical Nurse license; or Acute Care Nurse Practitioner license Demonstrated interpersonal/verbal communication skills Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Proficient in Microsoft Office Knowledge of healthcare delivery Understanding of data analysis and continuous quality improvement process Desired Skills Health Care Quality and Management Certified Healthcare Professional Certified Professional in Healthcare Quality

Job Description: Quality Information Specialist Quality Information Specialist Location: Jacksonville, FL Salary:  Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1014668       About the Opportunity An established managed care organization located in Jacksonville, FL is actively seeking a compassionate and driven healthcare professional for a promising opportunity on their staff as a Quality Information Specialist. In this role, the Quality Information Specialist establishes and fosters a healthy working relationship between large physician practices, IPAs and the organization. For the right candidate, this role has the potential to transition into a full-time opportunity. Apply today! Company Description Managed Care Organization Job Description The Quality Information Specialist (RN): Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the organization can provide support Develops, enhances and maintains provider clinical relationship across product lines Leads and/or supports collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Provides resources and educational opportunities to provider and staff Captures concerns and issues in action plans as agreed upon by provider Required Skills Bachelor's Degree in Nursing or equivalent work experience of 3+ years directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement; or 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience One of the following: LPN, RN, APRN Proficient in Microsoft Office programs Proficient in Generic Healthcare Management Systems Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions Demonstrated interpersonal/verbal communication skills Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Ability to multitask Desired Skills Master's Degree in Nursing One fo the following: HCQM, CHP, CPHQ

Job Description: Quality Information Specialist Quality Information Specialist Location: Fort Myers, FL Salary:  Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1014671       About the Opportunity An established managed care organization located in Fort Myers, FL is actively seeking a compassionate and driven healthcare professional for a promising opportunity on their staff as a Quality Information Specialist. In this role, the Quality Information Specialist establishes and fosters a healthy working relationship between large physician practices, IPAs and the organization. For the right candidate, this role has the potential to transition into a full-time opportunity. Apply today! Company Description Managed Care Organization Job Description The Quality Information Specialist (RN): Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the organization can provide support Develops, enhances and maintains provider clinical relationship across product lines Leads and/or supports collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Provides resources and educational opportunities to provider and staff Captures concerns and issues in action plans as agreed upon by provider Required Skills Bachelor's Degree in Nursing or equivalent work experience of 3+ years directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement; or 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience One of the following: LPN, RN, APRN Proficient in Microsoft Office programs Proficient in Generic Healthcare Management Systems Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions Demonstrated interpersonal/verbal communication skills Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Ability to multitask Desired Skills Master's Degree in Nursing One fo the following: HCQM, CHP, CPHQ

Job Description: Quality Review Specialist (RN) Quality Review Specialist (RN) Location: Brooklyn, NY Salary: $85,000-$100,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J134745       About the Opportunity A medical facility in New York City is currently seeking a licensed Registered Nurse (RN) for a promising Quality Review Specialist position with their growing staff. In this role, the Quality Review Specialist (RN) will be responsible for quality assurance, accuracy and overall integrity of the care management records and documentation completed by Care Management staff. Apply today! Company Description Medical Facility Job Description The Quality Review Specialist (RN): Ensures compliance with NYS DOH and CMS regulations through development of auditing tools, specifically validating all data collected Analyzes collected audit data, identify trends for staff re-training and implementing corrective action plans in collaboration with Clinical management staff Provides support to Directors, Managers and Supervisors to insure that all documentation and reporting requirements are prepared and maintained in a professional and well-coordinated manner Reviews, collects and prepares evidence packets for all scheduled fairs Required Skills 2+ years of Care Management experience Graduate from an accredited School of Nursing NYS Registered Nurse (RN) license Previous experience with Performance / Quality Improvement and Risk Management Computer savvy Microsoft Office/Suite proficient (Excel, Word, etc.) Knowledge of Medicare and Medicaid regulations Working knowledge of Audit techniques and methodologies Working knowledge of State and Federal regulations Solid analytical and critical thinking skills Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills BSN or Bachelor's Degree in a related field Microsoft PowerPoint proficient

Job Description: Quality Practice Advisor Quality Practice Advisor Location: Jacksonville, FL Salary: $60,000-$85,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J137523       About the Opportunity An established managed care company in Jacksonville, FL is actively seeking a self-motivated and dynamic individual for a promising opportunity on their staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor establishes and fosters a healthy working relationship between large physician practices, IPAs and the company. Apply today! Company Description Managed Care Company Job Description The Quality Practice Advisor: Advises and educates large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the company can provide support Develops, enhances and maintains provider clinical relationship across product lines Defines gaps in the company's service relationship with providers and facilitate resolution Leads and/or supports collaborative business partnerships Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Required Skills Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field One of the following: Certified Coding Specialist (CCS), LPN, LCSW, LMHC, LMSW, LMFT,  LVN, RN, NP, record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 3+ years of directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement 1+ year of experience in Managed Care  3 + years of directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement 2+ years of experience in directly related HEDIS medical Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Desired Skills Master's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field

Job Description: Quality Practice Advisor Quality Practice Advisor Location: Trenton, NJ Salary:  Experience: 3. year(s) Job Type: Temporary / Consulting Job ID: U1011207       About the Opportunity A healthcare company in New Jersey is actively seeking a licensed / certified professional to join their growing staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor will be responsible for educating providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Apply today! Company Description Healthcare Company Job Description The Quality Practice Advisor will be responsible for: Advising and educating large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collecting, summarizing and trending provider performance data to identify and strategize opportunities for provider improvement Delivering provider specific metrics and coach providers on gap closing opportunities Identifying specific practice needs where the company can provide support Developing, enhancing and maintaining provider clinical relationship across product lines Leading and/or supporting collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partnering with Physicians / Physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Providing resources and educational opportunities to provider and staff Documenting action plans and details of visits and outcomes and reporting critical incidents and information regarding quality of care issues Communicating with external data sources as needed to gather data necessary to measure identified outcomes Required Skills 3+ years of directly-related experience in HEDIS record collection with analytical review / evaluation and/or Quality Improvement; 1+ year of Managed Care experience Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field One of the following licenses: Certified Coding Specialist (CCS); Licensed Practical Nurse (LPN); Licensed Clinical Social Worker (LCSW); Licensed Mental Health Counselor (LMHC); Licensed Master Social Work (LMSW); Licensed Marital and Family Therapist (LMFT); Licensed Vocational Nurse (LVN); Licensed Registered Nurse (RN); and/or, Acute Care Nurse Practitioner (APRN) (ACNP-BC) Solid analytical skills Computer savvy Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Master's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field One of the following licenses: Health Care Quality and Management (HCQM); Certified Healthcare Professional (CHP); and, Certified Professional in Healthcare Quality (CPHQ)

Job Description: Quality Practice Advisor (HEDIS) Quality Practice Advisor (HEDIS) Location: Newark, NJ Salary:  Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1011592       About the Opportunity A recognized healthcare organization located in Newark is actively seeking a diligent and driven healthcare professional, with a strong HEDIS background, for a promising opportunity on their staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor establishes and fosters a healthy working relationship between large physician practices, IPAs and the organization. Company Description Healthcare Organization Job Description The Quality Practice Advisor: Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters) Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the organization can provide support Develops, enhances and maintains provider clinical relationship across product lines Leads and/or supports collaborative business partnerships Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education. Provides resources and educational opportunities to provider and staff Captures concerns and issues in action plans as agreed upon by provider   Required Skills BSN or equivalent work experience of 3+ years directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience One of the following: LPN, RN, APRN Proficient ion Healthcare Management Systems Intermediate knowledge of Microsoft Office Suite Demonstrated analytical skills (Intermediate) Demonstrated customer service skills (Intermediate) Ability to analyze information and covert related activities into a comprehensive work plan Desired Skills MSN HCQM, CHP, or CPHQ

Job Description: Quality Practice Advisor Quality Practice Advisor Location: Jacksonville, FL Salary:  Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1011417       About the Opportunity A widely recognized managed care organization headquartered in Jacksonville, FL is actively seeking a self-motivated and compassionate healthcare professional fro a promising opportunity on their staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Company Description Managed Care Organization Job Description The Quality Practice Advisor (RN): Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations Delivers provider specific metrics and coach providers on gap closing opportunities Identifies specific practice needs where the organization can provide support Develops, enhances and maintains provider clinical relationship across product lines Defines gaps in the organization's service relationship with providers and facilitate resolution Leads and/or supports collaborative business partnerships Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Provides resources and educational opportunities to provider and staff Captures concerns and issues in action plans as agreed upon by provider Required Skills Bachelor's Degree in Nursing or equivalent work experience of 3 + years directly related HEDIS record collection with analytical review/evaluation and / or Quality Improvement 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff 1+ year of experience in Managed Care experience One of the following licenses:  Licensed Practical Nurse, Registered Nurse (RN), Acute Care Nurse Practitioner (APRN) Demonstrated interpersonal/verbal communication skills Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Ability to implement process improvements Knowledge of healthcare delivery Proficient in Microsoft Office programs and Healthcare Management Systems Desired Skills Master's Degree in Nursing

Job Description: Quality Practice Advisor (RN) Quality Practice Advisor (RN) Location: Tampa, FL Salary:  Experience: 3.0 year(s) Job Type: Temporary / Consulting Job ID: U1011418       About the Opportunity A Florida-based healthcare company is currently seeking a licensed Registered Nurse (RN) to join their staff as a Quality Practice Advisor. In this role, the Quality Practice Advisor (RN) will be responsible for strategizing with providers at their medical offices to close care gaps and provide guidance on quality measures, educating providers, etc. Apply today! Company Description Healthcare Company Job Description The Quality Practice Advisor (RN) will be responsible for: Advising and educating large Provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements Collecting, summarizing and trending provider performance data to identify and strategize opportunities for provider improvement Identifying specific practice needs where the company can provide support Developing, enhancing and maintaining provider clinical relationship across product lines Leading and/or supporting collaborative business partnerships, elicit client understanding and insight to advise and make recommendations Partnering with Physicians / Physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education Providing communication, such as: newsletter articles; member education; outreach interventions; and, provider education Supporting quality improvement HEDIS and program studies as needed; requesting records from providers; maintaining databases; and, researching to identify members' provider encounter history Required Skills 3+ years of directly related HEDIS record collection experience; 2+ years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience; 1+ year of Managed Care experience Bachelor's Degree in Nursing FL Registered Nurse (RN), Licensed Practical Nurse (LPN), and/or Acute Care Nurse Practitioner (APRN) license Knowledge of Medical terminology and/or experience with CPT and ICD-9 coding (Intermediate) Microsoft Office/Suite proficient (Excel, PowerPoint, Outlook, Word, etc.) Knowledge of Healthcare delivery (Intermediate) Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Master's Degree in Nursing Active license in: Health Care Quality and Management (HCQM); Certified Healthcare Professional (CHP); and, Certified Professional in Healthcare Quality (CPHQ)

Job Description: Case Manager Specialist (RN) Case Manager Specialist (RN) Location: Piscataway, NJ Salary: $37-$47 per hour Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1007950       About the Opportunity A managed care organization in New Jersey is currently seeking a licensed Registered Nurse (RN) for a promising Case Manager Specialist position with their growing staff. In this role, the Case Manager Specialist (RN) will be responsible for planning, implementing, and evaluating appropriate health care services in conjunction with the physician treatment plan. Apply today! Company Description Managed Care Organization Job Description The Case Manager Specialist (RN): Handles more complex, high acuity cases, and/or account sensitive cases involving largest reserves Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for members Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services Reviews initial liability disability claims to determine extent and impact of insureds medical condition, medical restrictions and limitations and expected duration Performs leadership role on team when implementing new tools or case management programs / initiatives Required Skills 2+ years of previous Case Management experience in a Managed Care setting; 2+ years of Medical-Surgical experience NJ Registered Nurse (RN) license Working knowledge of Quality Control Medical Management system Microsoft Office/Suite proficient Patient oriented Proven research and analytical skills Solid time management and problem solving skills Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Knowledge of Managed Care

Job Description: Utilization Management Compliance Specialist (RN) Utilization Management Compliance Specialist (RN) Location: New York, NY Salary:  Experience: 5.0 year(s) Job Type: Temporary / Consulting Job ID: J136922       About the Opportunity A widely recognized healthcare facility located in New York City is actively seeking a self-motivated and diligent Registered Nurse (RN) for a promising opportunity on their staff as a Utilization Management Compliance Specialist. In this role, the Utilization Management Compliance Specialist implements compliance programs, policies and procedures designed to ensure compliance with all applicable federal laws, regulations and delegation requirements. Apply today! Company Description Healthcare Facility Job Description The Utilization Management Compliance Specialist (RN): Analyzes delegation audit results and makes recommendations for improvement Identifies and communicates with appropriate departments, teams, and key leadership on internal audit results and/ or deficiencies Prepares audit files for submission as required Participates in delegation audits, supplying information as needed Performs tasks related to external audits from contracted health plans/employer groups as well as pre-delegation review with potential health plans as required Coordinates with delegated partners to ensure adherence to all regulations, contractual agreements, NCQA, and URAC guidelines Follows up on corrective action plans ensuring timely closure Prepares adverse determination notices in compliance with regulatory requirements Required Skills Graduate of an accredited school of nursing with a minimum of an ASN Active Registered Nurse license 5+ years of total experience 2+ years of utilization management experience Working knowledge and understanding of basic utilization management and quality improvement concepts Polished and professional demeanor Ability to multitask Excellent communication skills   Desired Skills BSN Experience in assisted reproductive technology including general infertility, IVF or infertility care management, or women’s health

Job Description: Retention Specialist Retention Specialist Location: Newark, NJ Salary:  Experience: 3.0 year(s) Job Type: Temporary / Consulting Job ID: U1016538       About the Opportunity An established managed care company in Newark, NJ is actively seeking a self-motivated and highly organized professional for a promising opportunity on their staff as a Retention Specialist. Reporting to the Manager of Operations, the Retention Specialist works closely with the Operational areas in to identify real time abrasion/disenrollment potentials. Apply today! Company Description Managed Care Company Job Description The Retention Specialist: Analyze reports, claims denials, front-end rejects, and denials reason codes to determine appropriateness and areas of intervention Determine report specifications for ad-hoc reports needed for key abrasion/retention efforts and summarize accordingly Analyze daily call contact reports to determine accuracy, follow up, time frames and possible disenrollment threats Contact Members at risk for disenrollment based on report analysis and act as an elevated resolution team Identify additional areas of clarification needed for members and providers based on call contact reports and claims reporting Communicate findings to Operations, Marketing, Quality to facilitate the creation of needed job aides Monitor analyze and report information from Results (outsource vendor) for disenrollment survey information Communicate with the Operations Manager weekly regarding key areas of member and provider abrasion for tracking and trending Analyze grievance report data to determine trends Work with the Operations Manager on the Maintenance of Sharepoint communication documents Required Skills Associate's Degree in a related field 3+ years of experience in managed care or health plan focusing on claims processing, reimbursement methodologies and charge systems Demonstrated analytical skills Project management skills Proficiency with Microsoft Office programs Demonstrated written communication skills Ability to multitask Desired Skills Bachelor's Degree in a related field 2+ years of experience in data analysis/financial analysis with healthcare data Government programs experience (Medicare and Medicaid)

Job Description: Family Nurse Practitioner (FNP / APRN) Family Nurse Practitioner (FNP / APRN) Location: New Haven County, CT Salary: $90,000-$120,000 Experience: 1.0 year(s) Job Type: Full-Time Job ID: J137684       About the Opportunity A respected healthcare facility located in New Haven County, CT is actively seeking a compassionate and self-motivated Family Nurse Practitioner (FNP / APRN) for a promising opportunity on their staff. In this role, the Family Nurse Practitioner will provide primary care in outpatient offices. Apply today! Company Description Healthcare Facility Job Description The Family Nurse Practitioner (FNP / APRN) will: Order, perform and interpret diagnostic tests Create treatment plans Initiate appropriate specialty referrals Collaborate on improvement in care delivery and service with management and other physicians and staff Work with care team to close care gaps and improve quality measures Participate in Patient-Centered Medical Home (PCMH) and Accountable Care Organization (ACO) initiatives Work with practice management to ensure compliance with billing and coding requirements Provide on call coverage within the primary care group Required Skills MSN Graduation from accredited APRN or PA program Valid and unrestricted Connecticut FNP or APRN license Valid DEA registration and Controlled Substance Certificate 1+ year of experience in primary care Strong clinical skills and knowledge Patient-oriented

Job Description: Float Family Nurse Practitioner (NP) Float Family Nurse Practitioner (NP) Location: New London County, CT Salary: $90,000-$110,000 Experience: 0.0 year(s) Job Type: Full-Time Job ID: J135462       About the Opportunity A premier community health center located in New London County, CT is actively seeking a patient-oriented and diligent Nurse Practitioner (NP) for a rewarding Float Family role on their staff. In this role, the Float Family NP will provide quality primary care services, including routine and appropriate ambulatory adult, pediatric, and gynecological care as assigned. Apply today! Company Description Community Health Center Job Description The Float Family Nurse Practitioner (NP): Performs therapeutic procedures such as injections, immunizations, suturing, wound care, and managing infection Instructs and counsels patients regarding compliance with prescribed therapeutic regimens, normal growth and development Develops and implements patient management plans Performs comprehensive physical examination Compiles patient medical data including health history and results of physical examination Required Skills Active Nurse Practitioner license Strong clinical skills and knowledge Patient-oriented Demonstrated knowledge and skills necessary to provide care appropriate to the age of the patients served Demonstrated knowledge of the principles of growth and development over the life span as pertains to scope of practice Compassionate and empathetic Exceptional communication skills

Job Description: Psychiatry Nurse Practitioner (NP) Psychiatry Nurse Practitioner (NP) Location: Stamford, CT Salary: $96,000-$121,000 Experience: 1.0 year(s) Job Type: Full-Time Job ID: J131062       About the Opportunity A medical facility in Connecticut is currently seeking a licensed Nurse Practitioner, with a strong Psychiatric background, for a promising position with their growing staff. In this role, the Psychiatry Nurse Practitioner (NP) will be responsible for providing professionally skilled psychiatric evaluation, treatment, and appropriate disposition of patients presenting with psychiatric symptomatology. Company Description Medical Facility Job Description The Psychiatry Nurse Practitioner (NP): Performs medical and psychiatric history taking, utilizes appropriate diagnostic techniques and prepares a comprehensive psychiatric assessment report Completes accurate and appropriate orders; develops treatment plans in conjunction with physician; documents all aspects of care according to standards Recognizes and evaluates patients who require immediate attention of a physician, and when necessary, initiates emergency psychiatric treatments Provides after hours psychiatry coverage at the hospital when requested to do so by Department Chair or designee Provides necessary education, instruction, and counseling as indicated after assessing the learning needs of the patient and family Conducts Managed Care pre-certifications for patients requiring admission to inpatient psychiatric care Keeps track of all consultations done by the Consultation-Liaison team and makes monthly report to Department Chair Performs history and physical examination on patients admitted to inpatient psychiatry unit Participates in departmental and hospital wide quality improvement and patient safety projects as requested by Department Chair or designee Performs Psychiatric care of patients on the Inpatient Psychiatry unit as well as in Psychiatry Consultation Liaison Service Participates in departmental and hospital wide committees when asked to do so by Department Chair or designee Prepares and submits accurate professional bills to hospital billing agency Required Skills 1+ year of related experience BSN / MSN CT Nurse Practitioner (NP) license Certification in specialty area of Psychiatry DEA and Controlled Substance Registration Patient oriented Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized $ Desired Skills 1+ year of Psychiatry work experience

Job Description: Compliance Coding Specialist Compliance Coding Specialist Location: Hartford County, CT Salary: $45,000-$52,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J135302       About the Opportunity A Connecticut-based primary care organization is looking to fill an immediate need with the addition of a new, experienced Compliance Coding Specialist to their staff. In this role, the Compliance Coding Specialist will be responsible for conducting coding and billing training for providers and billing staff as well as addressing coding / billing questions. Apply today! Company Description Primary Care Organization Job Description The Compliance Coding Specialist will be responsible for: Conduct new provider coding training Conduct new biller training Develop / update curriculum and training handbook as needed Manage Learning Management System (LMS) and web portal content Ensure completion of required LMS modules Review and respond to coding/billing questions from providers and staff Research any coding issues. Research updated coding information. Conduct coding reviews and on-going training programs to assure coding quality. Maintain knowledge of ICD9 / ICD10 and CPT classifications and coding of diagnoses and procedure Attend the Compliance Committee and Central Billing Office meetings as needed Provide other services as needed to assist in effective operations of the Compliance Program Required Skills 2+ years of progressive provider Coding / Training experience Bachelor's Degree in a related field Medical Coding certification required AAPC Certificate of ICD-10-CM proficiency Advanced knowledge of Medical terminology, accepted Medical abbreviations and their meanings Knowledge in the use of specialized references such as the ICD-9/ICD-10, CPT books. Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively

Job Description: Clinical Documentation Specialist (RN) Clinical Documentation Specialist (RN) Location: Hartford County, CT Salary: $70,000-$95,000 Experience: 4.0 year(s) Job Type: Full-Time Job ID: J134160       About the Opportunity A healthcare facility in Connecticut is currently seeking a licensed Registered Nurse (RN) to join their staff as a Clinical Documentation Specialist. In this role, the Clinical Documentation Specialist (RN) will be responsible for the clinically-based concurrent review of inpatient medical records to evaluate the utilization and documentation of acute care services supporting hospital’s quality care, health information management, charge capture and revenue improvement. Company Description Healthcare Facility Job Description The Clinical Documentation Specialist (RN) will be responsible for: Improving overall quality and completeness of clinical documentation to accurately reflect patient severity of illness and risk of mortality through extensive interaction with physician, case management, nursing staff, other patient caregivers Ensuring complete, accurate and timely documentation for clinical communication and charge capture based on medical record documentation Accurate establishment of clinical documentation and charge capture, researching and resolving charge system problems and analysis of current systems for purposes of identifying system improvements Documenting system performance to ensure accuracy, compliance and to improve revenue Working as part of multi-disciplinary team that includes clinical leadership and staff, charge entry, medical records, coding, billing, information systems, quality, and compliance Training staff responsible for charge capture, medical record documentation and collaborates with other departments in the development of improved systems Supporting and enhances the compliance effort of the Hospital and the System by adhering to all regulatory, departmental and organizational guidelines for charging and specific government regulations Required Skills 3+ years of Acute Care Hospital experience BSN CT Registered Nurse (RN) license Current Basic Life Support (BLS) certification Solid assessment and documentation skills Computer savvy Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills MSN Certified Coder

Job Description: Clinical Documentation Specialist (RN) Clinical Documentation Specialist (RN) Location: Albany, NY Salary:  Experience: 5.0 year(s) Job Type: Temporary / Consulting Job ID: U992747       About the Opportunity A healthcare facility in Upstate New York City is actively seeking a licensed Registered Nurse (RN) for a promising Clinical Documentation Specialist position with their growing medical staff. In this role, the Clinical Documentation Specialist (RN) will be responsible for providing clinically based concurrent review of inpatient medical records to assess and procure accurate and complete documentation of the patient's diagnoses and procedures. Company Description Healthcare Facility Job Description The Clinical Documentation Specialist (RN) will be responsible for facilitating clinically appropriate physician/clinical documentation of all patient conditions, treatments, and interventions to accurately reflect quality of care, severity of illness, and risk of mortality to support correct coding, reimbursement and quality initiatives. Required Skills 5+ years of Clinical experience with an Acute Care Inpatient background Critical Care or strong Medical/Surgical experience Experience with criteria-based chart review, such as Case Management, Utilization Management, Managed care, Quality Improvement. Computer savvy Microsoft Office/Suite proficient Solid critical thinking and analytical skills Excellent communication skills Strong attention to detail Highly organized $ Desired Skills BSN CCDS / CCS certification Previous Clinical Documentation experience Knowledge of healthcare regulations, including Medicare reimbursement system, coding structure and documentation requirements

Job Description: Family Nurse Practitioner (FNP) Family Nurse Practitioner (FNP) Location: New Britain, CT Salary: $90,000-$110,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J132623       About the Opportunity A healthcare facility in Connecticut is actively seeking a licensed Family Nurse Practitioner (FNP) for a promising position with their growing staff. In this role, the Family Nurse Practitioner (FNP) will be responsible for providing the continuity of car to clients by established an ongoing primary care / client relationships with individual and their families. This is a great opportunity for a diligent and dedicated Family Nurse Practitioner (FNP) to gain valuable work experience and further their career at an established facility in Hartford County. Apply today! Company Description Healthcare Organization Job Description The Family Nurse Practitioner (FNP) will be responsible for Practicing and contributing to the development of evidence-based medicine Participating in quality improvement initiatives and educational enrichment, such as Grand Rounds Collaborate with a team of Medical Assistants (MAs) and Registered Nurses (RNs) Utilizing a Meaningful Use (MU) certified electronic health platform to document and manage patient information and communicate with other team members Assessing, diagnosing and managing acute and chronic health problems using the models of planned care and the chronic care model Performing comprehensive health histories and physical assessments developing appropriate treatment plans Required Skills 2+ years of experience eating Acute and Chronic patient issues Master's Degree in Nursing Active CT Family Nurse Practitioner (FNP) license Previous experience working in an Emergency Room, Primary Care and/or Urgent Care setting Solid assessment, clinical, and documentation skills Patient-oriented Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Bilingual (English and Spanish or Polish)

Job Description: Clinical Coordinator / Education Specialist (RN) Clinical Coordinator / Education Specialist (RN) Location: Sparta,NJ Salary: $80,000-$95,000 Experience: 0.0 year(s) Job Type: Full-Time Job ID: J137570       About the Opportunity A widely recognized healthcare facility located in Sparta, NJ is seeking a self-motivated and compassionate Registered Nurse (RN) for a promising opportunity on their staff as a Clinical Coordinator / Education Specialist. In this role, the Clinical Coordinator / Education Specialist works closely with the healthcare facility and Clinical Integration partners, as well as various referral sources to ensure patients receive timely and high-quality care. Apply today! Company Description Healthcare Facility Job Description The Clinical Coordinator / Education Specialist (RN) will: Promote timely access to appropriate care for referrals Reduce emergency room utilization and hospital admissions Decrease repetitive and/or unnecessary testing and diagnostics Increase patient comprehension of disease process and management through culturally and linguistically appropriate education Create and promote adherence to oncology and co-morbid care plan, developed in coordination with the patient, oncologist and primary care provider Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals Increase patients’ ability for self-management and shared decision-making Provide medication reconciliation and education Connect patients to relevant community resources to support the patient medically, emotionally, and financially Required Skills BSN Active New Jersey State Registered Nurse license Demonstrated clinical oncology background Experience in leadership and/or education Strong communication skills Proven organizational skills Knowledge of community resources Desired Skills Knowledge of Medicare Experience with IT systems and reports

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Are you a nurse with sharp analytical skills? Think you have the know-how to improve the healthcare standards in a medical facility? Quality management specialist jobs may be the perfect career move!

A safe environment and top quality care are necessities for all healthcare facilities. As a quality management specialist, you will play a vital role in improving facility wide standards; thereby ensuring patients receive optimal care.

By analyzing healthcare data, quality management specialists ensure their facility is in compliance with all rules and regulations while finding opportunities for improvement. They may use facility complaints, surveys and management statistics to help them create improvement plans that address pertinent issues. In the event the improvement plan doesn’t resolve the problem, quality management specialists must come up with a different plan.

Although quality management specialists are typically RNs, some may be physician’s assistants or physicians. Prior clinical experience is required, and candidates should have strong organizational and communication skills.

Ready to start looking for quality management specialist positions? Check out ADVANCE Healthcare Jobs today and start applying! Make sure you sign up for ADVANCE Messenger to get notified whenever new quality management specialist jobs are posted!