75 Matrix Medical Network Quality Assurance Analyst Jobs Hiring Near You

MATRIX MEDICAL NETWORK is dedicated to helping in the care of Medicare Advantage plan members. Our success comes as the result of our extraordinary people, years of experience, advanced technology and powerful information management capabilities. In partnership with health plans and medical service providers, we are establishing new standards in health care quality, efficiency and effectiveness.

The Nurse Practitioner (NP) acts as part of the clinical operations team and may be providing direct patient care in nursing homes, skilled nursing facilities (SNF) and home settings depending on the nature of the assignment or providing assessments to members in skilled nursing facilities and home settings. The responsibilities may include: geriatric assessment, medical history, physical exam, diagnosis and treatment, health education, physician referrals, case management referrals, follow-up and clear documentation according to Matrix guidelines and protocols. Nurse Practitioners are expected to meet Matrix standards for quality, service, productivity and teamwork. Consults with the Manager to ensure compliance with guidelines. Participates in Risk and Quality Management programs, clinical meetings and other meetings as required.

POSITION RESPONSIBILITIES:

Performs in-depth health risk assessments on all assigned members, in skilled nursing facilities (SNF), nursing care facilities or in members' homes.

May be responsible for care plans and treatment for members in medical management settings.

Works collaboratively with physicians, social workers, family, key care givers and any appropriate ancillary medical personnel. 

Responsible for implementing overall quality assurance activities, assessing, planning and administering health care which is individualized to the member and consistent with Matrix Medical Network policies and protocols.

Reviews and interprets the medical and social history of members.

Performs appropriate medical screening procedures for members.

Interprets laboratory data, orders additional laboratory investigations when indicated and ensures appropriate follow-up when assigned to medical management services.

Provides prescriptions and administers medications when assigned to medical management services.

Is compliant with OSHA, CLIA, State Board of Nursing and Federal DEA Board of regulations.

Participates in all mandatory compliance and other training programs, seeks guidance for compliance-related concerns and adheres to all applicable laws, regulations and Matrix Medical Network policies and procedures.

Refers members to quality, case management and disease management programs as necessary.

May act as a preceptor (Level 3 only)

Performs other duties as assigned.

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Requirements 

Bachelor of Science in Nursing preferred. Master's Degree required OR commensurate experience and satisfactory completion of NP licensure

Current RN and NP licensure in state of practice, Board certification by AANP or ANCC and Current CPR certification

Minimum 1 year clinical experience as a Nurse Practitioner in geriatric, adult or family practice setting.

Demonstrated record of consistently achieving clinical performance metrics in current role.

Proven ability to perform comprehensive, adult/geriatric physical exam

Demonstrated ability to identify, diagnose and document chronic disease in adults.  

Demonstrated ability to recognize conditions, characteristics, and behaviors that place seniors at risk.

Able to independently perform comprehensive physical exam

Proven ability to pursue feedback, continuing education and professional development.

Previous experience working with interdisciplinary teams and on special projects         

Travel Requirements: Travel required.       

Candidate will travel up to a 60 miles radius from their home zip code

Must have valid state driver license and be able to drive a car.

Must have proof of adequate automobile insurance coverage for the state of residence.

Must be able to travel by public transportation, and airplanes.

Must be able to independently travel to assigned locations.

Equal Opportunity Employer                                   

Matrix Medical Network does not discriminate in practices or employment opportunities on the basis of an individual's race, color, national or ethnic origin, religion, age, sex, gender, sexual orientation, marital status, veteran status, disability, or any other proscribed category set forth in federal or state regulations.

The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of the position.

Bachelor of Science in Nursing preferred. Master's Degree required OR commensurate experience and satisfactory completion of NP licensure

Current RN and NP licensure in state of practice, Board certification by AANP or ANCC and Current CPR certification

Minimum 1 year clinical experience as a Nurse Practitioner in geriatric, adult or family practice setting.

Demonstrated record of consistently achieving clinical performance metrics in current role.

Proven ability to perform comprehensive, adult/geriatric physical exam

Demonstrated ability to identify, diagnose and document chronic disease in adults.  

Demonstrated ability to recognize conditions, characteristics, and behaviors that place seniors at risk.

Able to independently perform comprehensive physical exam

Proven ability to pursue feedback, continuing education and professional development.

Previous experience working with interdisciplinary teams and on special projects         

All your information will be kept confidential according to EEO guidelines.