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Quality Review Nurse

Employer
York Risk Services Group
Location
Austin, Texas
Salary
Not Specified
Closing date
Mar 29, 2019

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Category
Health and Medical
Job Type
Not Specified
Career Level
Not Specified

Job Details

At York, we believe that an experience marked by expertise, consistency and compassion sets us apart. And we celebrate the diverse backgrounds and unique perspectives that allow us to stand apart from our competitors. Thats why we are committed to recruiting, developing and retaining people who represent our values and who believe in our mission.

Job Description

  • Review and evaluate case decisions applying quality assurance criteria, state regulations, and URAC requirements;
  • Ensure accuracy and completeness of documentation;
  • Communicate effectively any inconsistencies and/or inaccuracies;
  • Compile and summarize data for presentation;
  • Assist in the development and implementation of appropriate action plans to approve and assure compliance with regulatory requirements;
  • Participate and understand scope of responsibility in all ongoing QA Projects;
  • Adheres to quality assurance standards; and
  • Maintains objectivity and confidentiality.

EDUCATION:

  • Must have an unrestricted Texas RN/LVN license.

EXPERIENCE:

  • 2 years clinical experience.

SKILLS/ABILITIES:

  • Excellent grammar skills, critical thinking skills, and ability to manage time efficiently and meet stringent time frames.
  • Must be proficient in PC skills. (MS Word, Excel, and Outlook.)

KNOWLEDGE:

  • Must be knowledgeable of current URAC and multi-state regulations related to Workers' Compensation.
  • Must be knowledgeable of quality assessment and assurance procedures.
  • Must possess knowledge of medical terminology, medical records, and ICD 10.

Company

For more than 55 years, York has been delivering on our mission of reducing risk and getting people and organizations back to health, work and productivity. We’re committed to recruiting, developing and retaining people who represent our values and who believe in our mission. Our associates come from all walks of life but are single-minded in the pursuit of doing right by those we serve. We want each experience for our clients to be marked by expertise, consistency, and compassion because that’s what sets us apart. And we know for certain that it’s our people who allow us to say, boldly and proudly, that York is behind every good outcome.

Company info
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