Population Health Quality Reviewer
Conducts daily reviews of case files, letters, and database records against required criteria. Ensures compliance with VNSNY Home care policies and procedures, regulatory requirements and business practices up to an including contractual arrangements with payers. Prepares summary reports and provides recommendations to reduce errors and improve process performance. Works under general supervision. Licensure: Current license and registration to practice as a Registered Professional Nurse in New York State required. Education: Bachelor’s or Master’s degree in nursing required. Experience: Minimum four years professional experience in health care, including a minimum of two years in Quality , required. Excellent verbal/written communication skills required. Proficient computer and typing skills, and knowledge of Microsoft Office (Word and Excel) and database software required. Experience in one or more of the following areas: Audits, Compliance, and Medicare/Medicaid reporting required. Excellent verbal and written, presentation, communication, and writing skills required. Demonstrated ability to work effectively with employees at all levels of the organization required.