Employer Industry: Risk Management Solutions

Why Consider this Job Opportunity:
- Competitive pay up to $91,580
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including medical, dental, vision, and life insurance
- Strong, supportive culture with plenty of career advancement opportunities
- Ability to make a positive impact in the risk management industry
- Work-life balance with paid time off and other flexible benefits

What to Expect (Job Responsibilities):
- Develop, implement, and provide ongoing quality assurance calibration of processes
- Educate and equip operations with performance measurement and reporting tools
- Provide national account and regulatory quality oversight
- Interface with utilization review managers regarding compliance with organizational policies and procedures
- Review results and outcomes with general management and case management leadership

What is Required (Qualifications):
- Graduate of accredited school of nursing with a diploma/Associate degree
- 3 or more years of recent clinical experience, preferably in rehabilitation
- National certification (CRC, CIRS, CCRN, CVE, CCM, etc.), CCM preferred
- 4 years of utilization management experience; OR equivalent combination of training, education, and experience
- Prior quality assurance, utilization review, and/or training experience a plus
- Current RN licensure

How to Stand Out (Preferred Qualifications):
- Prior experience interacting with regulatory agency contacts
- Writing policies and procedures for URAC compliance
- Familiarity with legal and regulatory research related to workers' compensation utilization management laws, regulations, rules, and URAC standards interpretation

#RiskManagement #QualityAssurance #CareerAdvancement #CompetitivePay #HealthcareServices

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