Senior Registered Nurse

2 weeks ago


Arlington MA United States Mass General Brigham Full time
Job Summary

Mass General Brigham is seeking a highly skilled Registered Nurse to fill the role of Senior Clinical Quality Assurance Nurse Auditor. This position will be responsible for coordinating clinical quality assurance activities, including the development and review of training materials, auditing, and preparation for NCQA audits.

Key Responsibilities
  • Conduct monthly file audits to ensure compliance with clinical processes and NCQA standards.
  • Participate in and/or lead clinical Inter-rater Reliability Testing (IRR) to evaluate individual compliance.
  • Collaborate with the Clinical Quality Assurance Manager to develop and maintain a Quality Assurance (QA) plan, including auditing, analyzing, and strategizing process refinements and program improvements.
  • Develop written summaries of key areas of training required for clinical staff based on audit results.
  • Monitor staff adherence to designated NCQA UM, CCM, QI, and other standards, contractual, and regulatory requirements.
  • Communicate recommendations for operational changes based on survey findings to Quality and Clinical leadership.
  • Participate in training activities for clinical staff to support adherence to NCQA and other regulatory and internal documentation standards/requirements.
Requirements
  • Registered Nurse with 5-10 years of clinical experience in a healthcare setting.
  • Valid unrestricted Massachusetts RN professional license.
  • Quality Assurance auditing experience a plus.
  • NCQA experience preferred.
  • Complex Care Management experience preferred.
  • Utilization Management (InterQual) experience preferred.
About Mass General Brigham

Mass General Brigham is a leading integrated healthcare system committed to delivering high-quality, safe, and accessible care to patients and communities. Our hospitals are consistently ranked as top hospitals by U.S. World News Report.

Benefits
  • Medical benefits
  • Dental benefits
  • Vision benefits
  • Life insurance
  • Employee assistance programs


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