Healthcare Quality Assurance Specialist

1 week ago


Albany, New York, United States IPRO Full time
About IPRO

IPRO is a leading organization in the healthcare industry, dedicated to improving quality and reducing costs. Our team of experts works closely with government agencies, healthcare providers, and patients to ensure that high-quality care is delivered.

Job Summary

We are seeking a skilled Nursing Facility Resolution Reviewer to join our team. As a key member of our review process, you will be responsible for managing complaints related to nursing facility quality of care. Your expertise will help us identify areas for improvement and promote excellence in patient care.

Key Responsibilities
  • Interface with residents, their representatives, and nursing facilities to resolve complaints efficiently.
  • Conduct case processing, including preparing correspondence, assisting with mediation, and medical record reviews.
  • Promote compliance with timelines and confidentiality regulations.
Requirements
  • NYS Licensed RN required; Bachelor's degree in Nursing preferred.
  • Two years of experience in utilization review, claims adjudication, or similar activities; OR three years of clinical or administrative experience.
  • SMQT Certification desired.
What We Offer

At IPRO, we believe in providing competitive compensation packages. The annualized salary range for this position is $70,000 - $72,000. In addition to a base salary, you will also enjoy a range of benefits, including health insurance, retirement plans, and opportunities for professional growth.

Benefits
  • Affordable health insurance options.
  • Comprehensive retirement plans.
  • Opportunities for professional development and career advancement.


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