Compliance Nurse 2-LPN WAH AZ/CO/NM

Profile

Description

The Compliance Nurse 2 reviews medical management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Compliance Nurse 2 ensures nurse licensure and EMR access reporting is completed. Conducts and summarizes virtual SNF evaluations. Supports new hire onboarding/training and provides administrative support to the Regional Medical Director. Collects and analyzes data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and individuals. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications


Active LPN license in the state(s) in which the nurse is required to practice
Ability to be licensed in multiple states without restrictions
A minimum of three years varied nursing experience
Proficient with Microsoft Office products including Word, Excel and Outlook
Ability to work independently under general instructions and with a team
Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Preferred Qualifications


Experience Training/Mentoring/Precepting
Health Plan experience working with large carriers
Previous Medicare/Medicaid experience a plus
Previous experience in utilization management, case management, discharge planning and/or home health or rehab
Experience working with MCG
Experience with various EMR systems


Scheduled Weekly Hours

40

Company info

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