RN Quality Assurance Reviewer - Bilingual - Remote

Overview

The Registered Nurse, Quality Assurance Reviewer will work in conjunction with the Quality Manager and will be responsible for completing quality reviews for the Clinical Services and Provider Relations teams and reporting results. The role supports Quality Improvement Programs related to delegation, accreditation, and regulatory standards.

In Short

• Audit clinical documentation and calls to ensure compliance with standards.
• Ensure files comply with federal, state, and local CMS accreditation standards.
• Support clinical operations in pre-delegation and accreditation reviews.
• Maintain quality, organization, and project documentation.
• Prepare and audit files for external audits.
• Deliver weekly reporting statistics of audit activities.
• Be a subject matter expert in quality improvement initiatives.
• Navigate technical applications like Excel and PowerPoint.
• Participate in quality testing of electronic medical records system enhancements.
• Other duties as assigned.

Requirements

• Bilingual English/Spanish required.
• RN or LPN licensure and a Bachelor’s degree required.
• Three years of healthcare experience in care management or quality management.
• Experience in electronic medical records and data analysis.
• Knowledge of regulatory and accreditation agencies preferred.
• Experience monitoring calls of clinical staff preferred.

Benefits

• No travel required.