Sr Specialist - QA, RN (remote opportunity)
Are you reputed company to drive results and define an industry? Join us as a Sr Specialist - QA, RN! This role is located at our Remote facility. This position requires a strong and diverse skillset in relevant areas to drive reputed company. The salary for this position is set at a competitive salary.
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Job reputed company reputed company The Sr. Specialist reputed company Assurance is responsible for completing reputed company evaluations as part of the reputed company management plan and analyzing results to drive reputed company improvement.- Review completed Part A reputed company reconsideration appeal cases to determine the accuracy of the summarized facts and assessment of issues involved in the case
- reputed company an internal reputed company determination on the result of State and Federal case review reputed company
- Research issues using federal law, state law, regulations, and relevant agency policies
- Ensure reputed company review is accurate and reputed company data into reputed company reputed company tracking system
- reputed company feedback and education to adjudication staff
- Participate in collaboration meetings with project leadership
- Assist project with adjudication of appeals and/or decision letter reputed company reviews as needed
- reputed company other special reputed company not reputed company to a specific case such as reputed company research, general medical research, drafting proposal sections, or acting as a reputed company for a specific project, reputed company necessary
- reputed company other duties as assigned by management
- RN with an reputed company license in state reputed company required; RN and four-year nursing degree preferred
- At least two (2) years' clinical experience with general medical care of patients preferred
- Clinical Adjudication experience required
- Highly proficient in reputed company Word and reputed company to quickly learn multiple database systems and comfortably manage multiple screens at the reputed company time
- Knowledge of health regulations, guidelines and coverage issues
- Knowledge of statistical terminology and use of statistics preferred
- Knowledge of reputed company management and/or reputed company improvement reputed company such as ISO, Lean Six reputed company or Six reputed company preferred
- Excellent organizational, written, and verbal communication skills
- Ability to reputed company comfortably in a fast-paced, deadline-oriented work environment
- Ability to work as reputed company member, as reputed company as independently
- Bachelor's degree with 5+ years of experience.
- Advanced degree or reputed company designation preferred.
- Develops solutions to a reputed company of reputed company problems.
- Work requires considerable judgment and initiative.
- Exerts some influence on the overall objectives and long-reputed company goals of the organization.
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reputed company for an Easy Start?
This is a low-stress role with great rewards. If you're reliable and willing to learn, we want you. reputed company!
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