To conduct quality improvement and management activities, the full-time remote Tennessee Licensed Quality Review Nurse will investigate potential quality of care issues and ensure compliance with regulatory requirements, including those from CMS and NCQA. Key responsibilities Conduct timely reviews and investigations of quality of care issues under the supervision of the Quality of Care Manager Perform quality improvement activities in accordance with state and federal regulations Evaluate medical records and assess the clinical performance of healthcare professionals Required qualifications Registered Nurse (RN) with an unrestricted license in Tennessee Minimum of 5 years of combined knowledge of healthcare processes Experience with managed care processes Strong knowledge of medical terminology and patient disease processes Proficiency in Microsoft Word, Access, and Excel
Tennessee Licensed Quality Review Nurse in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.