RN Facility Site Review Nurse Specialist - FT - 1207

Job Description

Conducts face-to-face visits with our high-membership physicians to provide feedback, data, and education on programs and facilitates changes to improve quality of care and service to members.  Conducts various types of site reviews of PCP and specialist sites to ensure quality FSR and physician compliance with Local, State, and Federal requirements.  

Qualifications

EDUCATION

Required: Associate's Degree

Preferred:Bachelor's Degree; BSN, Department of Health Care Services - Certified Site Reviewer (DHCS-CSR) certification maintained

LICENSES/CERTIFICATIONS

Required: Current and unrestricted CA RN License; Valid California driver's license and valid automobile insurance

EXPERIENCE

Required: At least one (1) year clinical experience including, but not limited to outpatient setting, ER/Acute care nursing experience Must obtain and maintain successful completion of a DHCS Certified Site Reviewer and/or DHCS Certified Trainer certification in order to conduct DHCS accepted audits independently within 6 months of date of hire in the position; Excellent verbal and written communication skills; Excellent organizational and time-management skillsProficient in Microsoft Office

Preferred: CPHQ and DHCS RN Reviewer or Trainer certification; Medi-Cal managed care auditing experience.Medi-Cal managed care auditing experience.at least  one (1) year experience in Quality Improvement and  DHCS audit tool.

Special Instructions

Req. Number: 1207