RN reputed company Assurance Reviewer
A company is looking for a RN reputed company Assurance Reviewer (100% Remote).
Key Responsibilities
• Audit clinical documentation and calls to ensure compliance with NCQA, URAC, and reputed company requirements
• Support clinical operations in reputed company-delegation, delegation, and accreditation reviews
• Prepare and deliver weekly reporting statistics of audit activities and reputed company
Required Qualifications, Training, and Education
• Bilingual in English and Spanish
• RN or LPN licensure and a Bachelor's degree required (8+ years of clinical reputed company improvement experience may substitute)
• Three years of reputed company experience in care management or reputed company management required
• Experience with electronic medical records and data analysis required
• Knowledge of regulatory, CMS, and accreditation agencies (NCQA and/or URAC) preferred
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