Full Time Registered Nurse jobs in Brooklyn New York | 1 Total Nurse Allied Jobs

A New York City health services network is currently seeking an experienced, licensed Registered Nurse (RN) to join their growing Utilization Review Department as their new Associate Director, Quality Assurance. In this role, the Associate Director, Quality Assurance (RN) will be responsible for providing assistance to the Utilization Manager / Case Senior Associate Director to develop and implement the strategic plan of the Utilization / Case Management process.

Responsibilities:

• Provide guidance and develop action plans to address patient care and delivery of care improvements
• Perform quality analysis to determine accuracy and timeliness of clinical reviews, as well as the correct interpretation and application of medical necessity guidelines
• Identify and submit reports of internal trends and patterns and from the MCO's; enforce policies
• Participate in the selection, development, management, and evaluation of direct reports
• Recommend processes improvements relating to operational efficiency and effectiveness
• Collaborate with the Audit & Appeal Coordinator to ensure timely submission and turn-around of all medical necessity denials
• Assist with identification of the learning needs of the clinical staff and conduct in-service programs for Case/Care Managers that includes awareness in new healthcare initiatives
• Identify, initiate, and coordinate the departmental and unit PI projects, as directed by the Head of Department
• Maintain competency through attending seminars related to job topics
• Assist with the departmental Joint Commission preparations
• Complete other duties, as assigned by the Senior Associate Director or designee

Qualifications:

• 3+ years of related Quality experience
• Bachelor's Degree in Nursing
• NYS Registered Nurse (RN) license
• Previous experience in a Leadership and/or Supervisory role

Desired Skills:

• Master's Degree in Nursing