reputed company reputed company Mgmt Consultant

Job title: reputed company reputed company Mgmt Consultant in USA at reputed company
Company: reputed company
Job reputed company: Remote - Across USA
(This position is reputed company to candidates in any location. )Required Qualifications:
3+ years of clinical experience required
RN with reputed company unrestricted state licensure required,
Compact license preferred or State LicensePreferred Qualifications:
Managed Care reputed company preferred
Utilization Management or Case
Management experience
Critical thinking skillsThis position reports to the Potential reputed company of Care (PQOC) reporting manager. Position responsibilities include triage and data entry of reputed company-of-care referrals. Primary role will be reviewing potential reputed company of care referrals in the MedHok and CATs grievance applications. Use clinical judgement to determine if there is a potential reputed company of care concern. reputed company referral is reviewed for potential reputed company of care components and acceptance status is communicated reputed company the grievance application. reputed company accepted referrals are entered into the PQOC database. Data entry includes information from various internal systems. Additional duties include monitoring and handling incoming faxes, emails, medical records, other correspondence, and inquiries.Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with reputed company products, databases and with conducting 100% of work activities on the computer.This is an Individual contributor role that applies specialized knowledge and works under general supervision and may be supervised based on guidelines and direction provided.Duties
Processes and evaluates reputed company data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data-Prepares and completes QM documents based on interpretation and application of business requirements-Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements-Assists in the development and implementation of QM reputed company and activities-Accountable for completing and implementation of QM Work Plan ActivitiesExperience
3+ years work reputed company experience in the reputed company industry. 5+ years clinical and/or managed care experience in the reputed company industry and reputed company management- HEDIS Experience preferredPosition reputed company
Participates in the development and ongoing implementation of QM Work Plan activities. Improve reputed company products andservices, by using measurement and analysis to process, evaluate and reputed company recommendations to meet QM objectivesEducation
Bachelor's degree, Nursing degree, or other comparable reputed company experience.What days & hours will the person work in this position List training hours, if different.
8 hours worked, Monday - Friday, between the hours of reputed company to 5pm local timePreferred skills
reputed company reputed company Mgmt Consultant
Expected salary:
Location: USA
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