Quality Assurance Nurse jobs in Saint Louis, MO

Quality Assurance Nurse Manager RN (QA Nurse Manager – RN) Skills and Characteristics:

Many skills and personality traits help to ensure that an individual accomplishes all goals as a Quality Assurance Nurse Manager. A successful candidate in this position must be well-organized, open-minded, decisive, and flexible. The Quality Assurance Nurse Manager - RN must be able to communicate well with others, work as a team, and lead others by example and direction. Good writing skills and extensive computer experience are necessary. Knowledge of the medical, insurance and basic health-care industries is a must.

Quality Assurance Nurse Manager RN Tasks and Responsibilities:

QA nurse manager RN reporting to the Director of Nursing provides the vision, leadership and management necessary to ensure that our building has the business operations strategy, plans and operational controls, administrative and reporting procedures, and people and systems in place to effectively grow the organization and ensure financial strength and operating efficiency.

Be able to produce, organize and analyze data to define and evaluate trends prior to the onset of compliance issues. Determine causation of such trends, applying change in the most appropriate manner with regards to profitability while maintaining practice within regulatory guidelines.

Ensure compliance with local, state, and federal laws, Medicare regulations and company policies and procedures.

Assist with development, oversight and management of documentation audits, policies, and procedures.

Monitors department workflow and schedule to ensure productivity expectations are met and to ensure effective operations / relations.

Advises of possible trends in inappropriate utilization (under and/over) of the Risk Adjustment.

Identify opportunities in the Focus Care system and other tools available to manage the workflow and improve HCC code capture/resolution more effectively.

Remain current on diagnosis coding guidelines and risk adjustment reimbursement reporting requirements.

Check chart assignments every day and accurately report all hours worked on a weekly basis.

Maintain quality and production standards required by company.

Comply with the Standards of Ethical Coding as set forth by the American Health Information

Strong clinical knowledge related to chronic illness diagnosis, treatment, and management.

Reliability and a commitment to meeting tight deadlines (24-hour turnaround time on all assigned charts.

Provides direction on the implementation and modification of policies, rules, regulations, and contracts to further the goals of the program.

Design strategy, systems, processes, guidelines, rules and standards that improve transition processes, reduce barriers to transitions from long-term care facilities, and support successful transitions.

Keen ability to lead high performing management team, with an ability to partner with a dynamic leadership team.

Stay abreast of all regulatory issues and changes that affect the company policy or including accreditation standards.

Maintain current business relationships allowing for continued new growth, meeting company goals as planned.

Quality Assurance Nurse Manager RN Requirements and Qualifications:

Registered Nurse (RN) with a Missouri license

Long-term care experience serving Medicaid population and/or individuals with disabilities.

At least one year of experience in Quality Assurance for Health Risk Assessments

Proficient in Microsoft Office – Outlook, MS Office-Word, Excel

Must maintain and meet HIPAA standards.

Ability to work in a fast-paced environment while remaining calm and professional.

Strong customer service orientation

Excellent organizational skills and must be detailed oriented.

Strong computer and typing skills.

Outstanding listening skills

Positive, friendly, approachable disposition

Why work with us?

• $8000 RN Retention Bonus
• Competitive Salary
• Medical, Dental, and Vision Insurance
• 401k Eligibility
• Paid Time Off
• Generous Referral bonus program
• Tuition Assistance as you further your career
• $1000 Referral Bonus program