Quality Assurance/Continuous Improvement Nurse, RN (Remote)
About the position Responsibilities • 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