RN - Utilization Management Educator & Quality Auditor
Apply NowCompany: Piedmont Healthcare
Location: Atlanta, GA 30349
Description:
Description:
JOB PURPOSE: This position is responsible to provide Utilization Management expertise and program development/operational support to the UM team and audit for compliance with CMS guidelines. This position is critical to staff growth and development and maintaining staff at the cutting edge of utilization review practice while complying with regulatory guidelines. The Utilization Management Educator & Quality Auditor will assess, plan, implement and improve methods and processes of education and training for meeting employee learning needs for enhancing job performance, competency, and overall program performance. The Utilization Management Educator & Quality Auditor will also act as the internal UM performance improvement coach and provide process evaluation and recommendations for process improvement.
Qualifications:
MINIMUM EDUCATION REQUIRED:
Bachelors degree in Nursing or a related field.
MINIMUM EXPERIENCE REQUIRED:
Three (3) years of experience in a broad range of clinical settings, utilization management, or case management. InterQual and MCG experience.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
Current License in the State of Georgia as a Registered Nurse or NLC/eNLC Multistate License.
ADDITIONAL QUALIFICATIONS:
Epic experience
InterQual Certified Instructor (IQCI).
JOB PURPOSE: This position is responsible to provide Utilization Management expertise and program development/operational support to the UM team and audit for compliance with CMS guidelines. This position is critical to staff growth and development and maintaining staff at the cutting edge of utilization review practice while complying with regulatory guidelines. The Utilization Management Educator & Quality Auditor will assess, plan, implement and improve methods and processes of education and training for meeting employee learning needs for enhancing job performance, competency, and overall program performance. The Utilization Management Educator & Quality Auditor will also act as the internal UM performance improvement coach and provide process evaluation and recommendations for process improvement.
Qualifications:
MINIMUM EDUCATION REQUIRED:
Bachelors degree in Nursing or a related field.
MINIMUM EXPERIENCE REQUIRED:
Three (3) years of experience in a broad range of clinical settings, utilization management, or case management. InterQual and MCG experience.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
Current License in the State of Georgia as a Registered Nurse or NLC/eNLC Multistate License.
ADDITIONAL QUALIFICATIONS:
Epic experience
InterQual Certified Instructor (IQCI).