Facility Site Review Nurse Specialist RN II
North American Staffing Group
Los Angeles, CA
Facility Site Review Nurse Specialist RN II
North American Staffing Group
Los Angeles, CA
Expired: over a month ago
Applications are no longer accepted.
- Full-Time
Job Description
Required:
Must obtain and maintain successful completion of a DHCS Certified Site Reviewer and/or DHCS Certified Trainer certification in order to conduct DHCS accepted audits independently within 6 months of date of hire in the position.
Preferred:
Certified Professional in Healthcare Quality (CPHQ) and Department of Health Care Services (DHCS)
RN Reviewer or Trainer certification.
Medica Talent Group is excited to share this direct-hire opportunity with you!
Our client, a well-known and reputable Managed Care Organization in the Los Angeles County area is seeking a Facility Site Review Nurse Specialist RN II to join their growing team. This is a wonderful opportunity for an individual seeking to expand their knowledge in the Managed Care arena. This organization offers competitive salary, full benefits and much more!
Job Summary:
The Facility Site Review Nurse Specialist RN II conducts face-to-face visits with our high-membership physicians to provide feedback, data, and education on programs and facilitates changes to improve quality of care and service to members. Conducts various types of site reviews of PCP and specialist sites to ensure quality FSR and physician compliance with Local, State, and Federal requirements.
The Facility Site Review Nurse Specialist RN II conducts face-to-face visits with our high-membership physicians to provide feedback, data, and education on programs and facilitates changes to improve quality of care and service to members. Conducts various types of site reviews of PCP and specialist sites to ensure quality FSR and physician compliance with Local, State, and Federal requirements.
Skills and Abilities:
Conducts Full Scope Reviews, Site Review Surveys, Medical Record Review Surveys, Specialty Site Review Surveys, PARS assessments, Focused Reviews, Interim Onsite Reviews, Consultation/Educational Site visits, Investigative visits, HEDIS related visits, and/or other appropriate site visits.
Conducts face-to-face visits with our high-membership physician sites to include the following: Provider feedback to providers on performance on HEDIS-related measures and incentives performance; give providers health education materials and clinical tools to facilitate improved screening, preventive care, and chronic disease management; promote clinical quality improvements in practices; and document outcomes and issues of site visits for review and data gathering to the FSR Manager.
Act as the provider quality improvement liaison (PQIL) to assess and communicate issues and improvement opportunities identified during the physician site visit to the FSR Manager for resolution and a plan of action. Information gathered from provider sites will be submitted as a report and discussed with the FSR Manager at least bimonthly as appropriate.
Communicates and coordinates information and findings from site visits between FSR Manager, internal and external staff and customers. Documents discussions and correspondence in FSR file as appropriate.
Assists and participates in the facilitation of disease management programs as implemented by the Quality Improvement (QI) department. Assists and participates in the Annual Audit of Plan Partners delegated for FSR.
Perform other duties as assigned.
Conducts face-to-face visits with our high-membership physician sites to include the following: Provider feedback to providers on performance on HEDIS-related measures and incentives performance; give providers health education materials and clinical tools to facilitate improved screening, preventive care, and chronic disease management; promote clinical quality improvements in practices; and document outcomes and issues of site visits for review and data gathering to the FSR Manager.
Act as the provider quality improvement liaison (PQIL) to assess and communicate issues and improvement opportunities identified during the physician site visit to the FSR Manager for resolution and a plan of action. Information gathered from provider sites will be submitted as a report and discussed with the FSR Manager at least bimonthly as appropriate.
Communicates and coordinates information and findings from site visits between FSR Manager, internal and external staff and customers. Documents discussions and correspondence in FSR file as appropriate.
Assists and participates in the facilitation of disease management programs as implemented by the Quality Improvement (QI) department. Assists and participates in the Annual Audit of Plan Partners delegated for FSR.
Perform other duties as assigned.
Education and Experience:
Required:
Associate's Degree in Nursing
Preferred:
Bachelor's Degree in Nursing
Associate's Degree in Nursing
Preferred:
Bachelor's Degree in Nursing
Required:
Must obtain and maintain successful completion of a DHCS Certified Site Reviewer and/or DHCS Certified Trainer certification in order to conduct DHCS accepted audits independently within 6 months of date of hire in the position.
Registered Nurse (RN) - Active, current and unrestricted California License
Preferred:
Certified Professional in Healthcare Quality (CPHQ) and Department of Health Care Services (DHCS)
RN Reviewer or Trainer certification.
INDMED
Address
North American Staffing Group
Los Angeles, CA
USA
Industry
Healthcare
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