Clinical Quality Manager, Registered Nurse (RN) - Remote

Description

Clinical Quality Manager

• Are you an experienced Clinical Manager looking for a new challenge?
• Do you value care management and quality improvement?
• Are you motivated, energetic, and excited to become part of the Kepro team?
  

If so, you might be our next new team member!

Who We Need

The Clinical Quality Manager is responsible for overseeing day-to-day operations of Quality Management. Responsible for the development and monitoring of quality monitoring activities.

Why us?

Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.

People Focused. Mission Driven.

Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.

We do this through our people.

At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.

Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.

What You'll Do

• Facilitates all QA activities, provides continuous improvement consulting services to internal customers and employs knowledge of performance improvement strategies, principles, methodology, techniques and data analysis.
• Ensures the implementation of key performance indicators and maintains systems for tracking, reporting and improving performance.
• Ensures the promotion of awareness of customer requirements throughout the operation.
• Completes audits & reviews audit results and identify the severity of audit findings or the risk associated with the findings.
• Reviews and evaluate reported crisis (i.e., highly-urgent service related problem with immediate negative implications for the Company) and assists to formulate a plan of action for handling the incident/issues based on area of expertise/responsibility. Execute QA plans to ensure they meet current and future business requirements (e.g., best practices, quality, volume and product growth, regulatory requirements, & new product introductions).
• Assist in preparing and submitting reports and/or deliverables timely as required
• Charter the LQIC, maintain quality improvement plans for contract and address any issues stemming from results of the plan.
  

What You'll Need

Required Qualifications

• Active unrestricted registered nurse license.
• Vast Knowledge of Medicaid & Utilization Management.
  

Experience

• Previous utilization management experience highly preferred.
  

Knowledge, Skills, Abilities

• Knowledge of InterQual criteria strongly preferred.
• Knowledge of current NCQA/URAC standards strongly preferred
• Medical record abstracting skills required.
• Knowledge of the organization of medical records, medical terminology, and disease process required.
• Strong clinical assessment and critical thinking skills required.
• Excellent verbal and written communication skills required.
• Ability to work in a team environment.
• Flexibility and strong organizational skills needed.
• Must be proficient in Microsoft Office and internet/web navigation.
  

Thank You!

We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Kepro Talent Acquisition Team

Mental And Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

Kepro offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our website at www.Kepro.com for more information on the Kepro Family of Companies.

EOE AA M/F/Vet/Disability

Kepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.