New Jersey Licensed Quality Assurance Specialist

A company is looking for a DSNP Quality Assurance Specialist. Key Responsibilities: Conduct audits on member charts to ensure compliance with regulatory requirements for MLTSS/DSNP care management operations Analyze and document audit outcomes, including error trends, and collaborate with management for follow-up actions Develop process improvement recommendations and assist in creating internal workflows for standardized audit guidelines Required Qualifications: High School Diploma/GED required; Bachelor's degree preferred or relevant experience in lieu of degree Minimum of 3 years experience in the health care delivery system/industry Experience in managed care and chart reviews is preferred Knowledge of regulatory agency standards and compliance experience is desired Preferred Licensed Registered Nurse

Mar 20, 2025 - 20:35

A company is looking for a DSNP Quality Assurance Specialist. Key Responsibilities: Conduct audits on member charts to ensure compliance with regulatory requirements for MLTSS/DSNP care management operations Analyze and document audit outcomes, including error trends, and collaborate with management for follow-up actions Develop process improvement recommendations and assist in creating internal workflows for standardized audit guidelines Required Qualifications: High School Diploma/GED required; Bachelor's degree preferred or relevant experience in lieu of degree Minimum of 3 years experience in the health care delivery system/industry Experience in managed care and chart reviews is preferred Knowledge of regulatory agency standards and compliance experience is desired Preferred Licensed Registered Nurse