Senior Registered Nurse

3 days ago

Brookline, Massachusetts, 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 for all file requirements.
  • Participate in and/or lead clinical Inter-rater Reliability Testing (IRR).
  • Proactively communicate and collaborate within the Clinical and Quality Departments to identify key areas of focus and develop a Quality Assurance (QA) plan.
  • Develop written summaries of specific key areas of training required for clinical staff based on audit results.
  • Monitor staff adherence to designated NCQA UM, NCQA Complex Care Management (CCM), Quality Improvement (QI), and other standards.
  • Work with the Clinical Quality Assurance Manager to communicate recommendations for operational changes based on survey findings.
  • Participate in training activities for clinical staff to support adherence to NCQA and other regulatory and internal documentation standards/requirements.
  • Support business requirements for system and process improvements.
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 Us

Mass General Brigham is a leading integrated healthcare system that provides innovative solutions centered on the health needs of its members. As a member of the Mass General Brigham team, you will have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.

We offer competitive salaries, a benefits package with flexible work options, career growth opportunities, and much more. If you are a motivated and results-oriented individual with a passion for quality assurance and clinical excellence, we encourage you to apply for this exciting opportunity.

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