Senior Clinical Admin Nurse RN Waltham, MA Work Monday
Location: Waltham Massachusetts
Description: UnitedHealth Group is currently seeking to employ Senior Clinical Admin Nurse RN Waltham, MA Work Monday right now, this position will be placed in Massachusetts. More details about this position opportunity please give attention to these descriptions. The Senior Clinical Admin Nurse checks for validity, accuracy, and completeness of comprehensive clinical ass! essments
Ensuring that the field clinicians comply with all applicable State and Federal regulations and consent decrees, as well as the applicable accrediting regulatory review agencies, including but not limited to CMS, NCQA, HIPAA, and all UHC policies and procedures as applicable
Reviews clinical data on Minimum Data Set – Home Care Assessment (MDS HC) to determine compliance with level of care contractual and regulatory requirements of the State Medicaid programs, prior to submission to the MMIS state system
Verifies and reviews for efficiencies and effectiveness of procedures
Maintains timely and accurate submission into the MMIS state application
Performs internal Quality Control reviews on processes and activities while developing recommendations for improvement
Serves as a catalyst for identifying and implementing process improvements designed to identify and correct deficiencies
Assists with the! coordination of internal/external audits and reviews
! Maintain extensive knowledge of regulatory and applicable accrediting body requirements becoming a Compliance resource for the team
Proficient in interpreting clinical notes and assessments completed by field nurses
Interact effectively with field clinicians and other departments
Establish and maintain good working relationships throughout the company to support goals and objectives
Demonstrate flexibility, availability, and dependability to conform to conform to position responsibilities
UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.
We contract with states and other government agencies to provide care for over two million ! individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach. This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Requirements
Requirements:
Requires current unrestricted MA RN licensure
Minimum 2 years clinical experience as an RN
Basic MicroSoft Word skills
Preferred/Asset Qualifications:
Experience with Clinical Quality
Diversity creates a healthier atmosphere: equal opportunity ! employer M/F/D/V
UnitedHealth Group is a drug-free workplace. ! Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to UnitedHealth Group.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Sat, 18 May 2013 10:49:43 GMT
Apply Senior Clinical Admin Nurse RN Waltham, MA Work Monday Here
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