RN Quality Assurance (Healthcare)

Tech Tammina LLC

RN Quality Assurance (Healthcare) Syracuse, NY

Job type -Temp to Hire:

pay range for this position is $25 - $41/hr.

Job Description :-

Serving in a clinical capacity, this individual will accurately and 

efficiently conduct medical reviews, including but not limited to 

HEDIS/Quality Assurance Reporting Requirements (QARR), DOH 

requests, prenatal and postpartum reporting and ad hoc requests 

from Medical Directors. The QA Nurse will also participate in the 

Quality Management program by identifying improvement 

opportunities, development of barrier analysis and assisting in 

development of interventions to improve outcomes. 

Conducts retrospective multiple medical record reviews to retrieve 

data for internal and external quality measures for HEDIS and QARR 

Abstracts data from medical records, uses portable scanner to 

retrieve relevant components of medical record (20%) 

Responsible for the integrity of the data that is collected. 

Identify improvement opportunities, conduct barrier analysis review, 

and develop interventions to address identified barriers (20%) 

Conduct telephonic outreach to members needing services identified 

Telephonic outreach to Educate Providers on measures Identified on 

Complies with all guidelines established by the Centers for Medicare 

and Medicaid (CMS) and guidelines set forth by other regulatory 

agencies, where applicable, and defined in the Universal American 

And all other duties assigned by the manager and/or supervisor 

Professional verbal and written communication skills, with the ability 

Organizational skills with the ability to handle multiple tasks and/or 

Time management skills with the ability to prioritize and schedule 

daily activities for the most efficient use of time

Problem solving skills with the ability to look for root causes and 

Must have a track record of producing work that is highly accurate, 

demonstrates attention to detail, and reflects well on the 

Responsibilities: 

reporting. (20%) 

on the Quality Workplan (20%) 

the Quality work plan (20%) 

Corporate and department policies.

Required Skills: 

to clearly articulate thoughts and ideas

projects at one time 

implementable, workable solutions 

organization 

Required Experience: 

Undergraduate degree or equivalent experience 

2 or more years of managed care experience 

Current, unrestricted RN license in NY 

Knowledge of ICD coding helpful

Quality Management, Case Management or Utilization Management 

Personal computer experience should include working with Microsoft 

Word, Excel, PowerPoint and Outlook at the intermediate level at a 

Universal American Corp. is an Equal Opportunity / Affirmative 

experience preferred 

minimum 

RN Quality Assurance (Healthcare) Syracuse, NY 

Action Employer and does not discriminate because of age, color, 

disability, ethnicity, marital or family status, national origin, race, 

religion, sex, sexual orientation, military veteran status, or any other 

characteristic protected by law. We are committed to attracting, 

retaining and maximizing the performance of a diverse and inclusive 

workforce. 

Work Environment / Physical Demands: 

Work is performed in a professional office setting, business casual 

dress environment. Working extended hours may be required as 

The physical demands for this position include exerting up to 10 

pounds of force occasionally, and/or a negligible amount of force 

frequently to lift, carry, push, pull or otherwise move objects, 

including the human body. This is considered sedentary work, which 

involves sitting most of the time; walking and standing are required, 

as well on occasion. Telephone work and/or computer work are 

typically required. Reasonable accommodations may be made to 

enable individuals with disabilities to perform the essential functions. 

needed.

Share the Profiles to paramesh(at)tammina(dot)com

Contact: 703-349-2332

Keep the subject line with Job Title and Location