VillageCare · 19 hours ago
Quality Assurance Clinical Auditor - RN
VillageCare is a community-based, not-for-profit organization serving people with chronic care needs. As a Quality Assurance Clinical Auditor - RN, you will ensure compliance with federal and New York State regulatory requirements, conduct audits, and support the development of policies and procedures to enhance healthcare quality.
Health CareHospitalNon Profit
Responsibilities
Ensuring that all Clinical and Medical Management activities adhere to federal and New York State regulatory requirements, including CMS and NYSDOH mandates
Identifying risks, developing processes, and conducting audits in collaboration with business owners to maintain compliance with healthcare standards
Supporting the development and revision of policies and procedures
Providing crucial training and support to both clinical and non-clinical staff
Monitoring regulatory changes and industry trends to educate colleagues and facilitate initiatives that promote a culture of excellence and integrity
Contributing to corrective action plans and compliance tracking to ensure that the organization remains audit-ready
Qualification
Required
Current NYS Registered Nurse License
Bachelor of Science in Nursing (BSN)
3-5 years of experience in Utilization Management or Managed Care
Specific knowledge of quality monitoring and compliance for Medicare lines of business
Proficiency in quality measurement systems
At least two years of experience in workforce development and resource management
Strong leadership, collaboration, and motivational skills
Ability to multitask and thrive in a fast-paced environment
Excellent written and verbal communication skills
Expertise in data analysis
Benefits
Generous PTO package
10 Paid Holidays
Personal and Sick time
Medical/Dental/Vision
HRA/FSA
Education Reimbursement
Retirement Savings 403(b) with a yearly 5% employer contribution
Life & Disability
Commuter Benefits
Paid Family Leave
Additional Employee Discounts
Company
VillageCare
VillageCare is a creative and creative ongoing care firm that helps hard to understand the present condition of need for people they serve.
Funding
Current Stage
Late StageRecent News
Business Journals
2023-04-26
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