Quality Assurance/Continuous Improvement Nurse, RN (Remote)
About the positionResponsibilities• Ensure the highest quality processes and activities are performed by the G&A clinical staff. • Assist in the development of quality initiatives and develop & implement the clinical QA Plan. • Perform standardized monitoring and auditing within the G&A department. • Develop and utilize quality auditing tools and summarize audit findings. • Identify training needs for the G&A clinical staff. • Identify Continuous Improvement opportunities through QA and LEAN activities.• Ensure compliance with regulatory standards, practices, and guidelines. • Lead and track Continuous improvement projects within the department. • Support quality assurance efforts related to appropriate Grievance case categorization. Requirements• Two (2) or more years of experience as an RN in case management, utilization management in managed care setting or related experience in a health care delivery setting. • Two (2) or more years of experience as an RN in clinical nursing in a hands-on patient care delivery setting.• Two (2) or more years of experience relevant to Grievance & Appeals case review. • Associate's degree in nursing from an accredited institution required. • Minimum possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California Board of Registered Nursing required. Nice-to-haves• Bachelor's degree in nursing from an accredited institution preferred. Benefits• Competitive salary• CalPERS retirement• State of the art fitness center on-site• Medical Insurance with Dental and Vision• Life, short-term, and long-term disability options• Career advancement opportunities and professional development.• Wellness programs that promote a healthy work-life balance• Flexible Spending Account - Health Care/Childcare• 457(b) option with a contribution match• Paid life insurance for employees• Pet care insurance Apply tot his job