AlbuquerqueRecruiter Since 2001
the smart solution for Albuquerque jobs

Compliance Specialist

Company: Careerbuilder-US
Location: Albuquerque
Posted on: January 12, 2021

Job Description:

Title: Compliance SpecialistMandatory skills:IPA training, Administrative Forums, MG QI Fund Training, IPA QI Fund Trainingcontractual arrangements, accreditation requirements, government regulationclinical nursing, regulatory standards, seminars, training sessionHIPAA, Diversity Principles, Corporate Integrity, Compliance Program policyclinicalUM, Case Management, quality improvement, project managementData analysisWord, Excel, PowerPointDescription:The Quality Management Specialist II performing the function of Critical Incident Coordinator:Responds to and conducts resulting follow-up activities to related Critical Incidents; andIs responsible for facilitating and monitoring of assigned quality improvement projects, including the following:Consult with network physicians, Medical Group/IPAs, providers, staff, members, and other resources, as appropriate, to assess, plan, facilitate implement, coordinate, monitor and evaluate options to meet clinical quality improvement project objectives and to promote high quality and cost effective outcomes.Gather information, analyzes and communicates it, and develops recommendations regarding clinical quality improvement projects.Assist in addressing issues related to clinical quality improvement projects for the managed care programs to assure compliance with contractual arrangements, accreditation requirements, government regulations and employer group expectations.Assist in coordinating internal support functions for assigned clinical quality improvement projects.Analyze statistical reports to evaluate effectiveness of quality improvement projects as well as to identify opportunities for improvement.Cooperate with other members of the department and interfacing departments as a team to increase overall efficiencies in an effort to maintain or decrease administrative costs.Provide ongoing documentation of clinical quality improvement project interventions for quarterly and annual Quality Improvement Reports, and for accreditation reviews ensuring reporting accuracy and timeliness.Present clinical quality improvement project results to the Quality Improvement Workgroups and Managed Care QI Committees.Functions as preceptor for orientation of new employees.Coordinates and provides interface with medical groups and other practitioners regarding existing and proposed clinical quality improvement initiatives.Assists in meeting and interfacing with outside agencies and organizations such as the New Mexico Human Services Department, Adult Protective Services, Children Youth and Families Department, etc.Maintains and enhances knowledge of clinical nursing and regulatory standards by attending seminars, training sessions, etc.Attends internal/external meetings to keep apprised of quality improvement and managed care issues/information.Assists in day-to-day activities in an effort to achieve QI annual divisional goals.Practices within the scope of licensure and/or certification and accreditation standards.Communicates and interacts effectively and professionally with co-workers, management, customers, etc.Complies with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.Maintains complete confidentiality of company business.Maintains communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.JOB REQUIREMENTS:Registered Nurse (RN), Licensed Practical Nurse (LPN), Respiratory Therapist, or other medical specialty, i.e. Physicians Assistant, Corpsman with unrestricted license in state.3 years clinical practice experience.2 years UM, Case Management, quality improvement and/or project management experience.Experience conducting presentations for member and/or provider training.Current New Mexico driver's license.Ability to travel including overnight stays.Verbal and written communications skills.Data analysis experience.PC proficiency to include Word, Excel, and PowerPoint.Job Requirements:Mandatory skills: IPA training, Administrative Forums, MG QI Fund Training, IPA QI Fund Trainingcontractual arrangements, accreditation requirements, government regulationclinical nursing, regulatory standards, seminars, training sessionHIPAA, Diversity Principles, Corporate Integrity, Compliance Program policyclinicalUM, Case Management, quality improvement, project managementData analysisWord, Excel, PowerPointVIVA USA is an equal opportunity employer and is committed to maintaining a professional working environment that is free from discrimination and unlawful harassment. The Management, contractors, and staff of VIVA USA shall respect others without regard to race, sex, religion, age, color, creed, national or ethnic origin, physical, mental or sensory disability, marital status, sexual orientation, or status as a Vietnam-era, recently separated veteran, Active war time or campaign badge veteran, Armed forces service medal veteran, or disabled veteran. Please contact us at hr@viva-it.com for any complaints, comments and suggestions.Please send your resumes to "staffing10@viva-it.com" and one of our recruiter will get in touch with you.Contact Details :Account co-ordinator: Dinesh Kumar U, Phone No: (847) 461-3640 , Email: staffing10@viva-it.comVIVA USA INC.3601 Algonquin Road, Suite 425Rolling Meadows, IL 60008staffing10@viva-it.com - http://www.viva-it.com

Keywords: Careerbuilder-US, Albuquerque , Compliance Specialist, Other , Albuquerque, New Mexico

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Radiologic Technologist / X-Ray Tech - Travel Contract
Description: br br br br Join expert X-Ray Technologists across the U.S. who are filling br vacant positions at local healthcare facilities experiencing rapid br growth or regional staffing shortages. (more...)
Company: Jackson Therapy Partners
Location: Albuquerque
Posted on: 01/24/2021

Commercial and Personal Insurance Account Managers
Description: The Sunderland Insurance Agency is currently seeking both: Commercial Lines CSR Personal Lines CSR The Sunderland Insurance Agency was founded in 1949 by Archie and Jean Sunderland. For over 70 years, (more...)
Company: Sunderland Insurance Agency
Location: Albuquerque
Posted on: 01/24/2021

Deliver with Uber on your schedule
Description: Deliver with Uber. Earn on your schedule. Work on your schedule. Deliver for a few hours in the mornings, every night, or just on weekends it's up to you. Earn Good Money. You'll earn by bringing people (more...)
Company: Uber Eats
Location: Tohatchi
Posted on: 01/24/2021


Albuquerque Calculus Tutor Jobs
Description: Albuquerque Calculus Tutor Jobs Varsity Tutors has students in Albuquerque looking for Calculus tutoring. Varsity Tutors is a live learning platform that connects tutors with
Company: Varsity Tutors
Location: Albuquerque
Posted on: 01/24/2021

Albuquerque Calculus 1 Tutor Jobs
Description: Albuquerque Calculus 1 Tutor Jobs Varsity Tutors has students in Albuquerque looking for Calculus 1 tutoring. Varsity Tutors is a live learning platform that connects tutors with students to provide (more...)
Company: Varsity Tutors
Location: Albuquerque
Posted on: 01/24/2021

Deliver with Uber on your schedule
Description: Deliver with Uber. Earn on your schedule. Work on your schedule. Deliver for a few hours in the mornings, every night, or just on weekends it's up to you. Earn Good Money. You'll earn by bringing people (more...)
Company: Uber Eats
Location: Bluewater
Posted on: 01/24/2021

Make up to $18/hour - Deliver with DoorDash
Description: Your time. Your Goals. What is DoorDash Available in over 4,000 cities in the U.S., Canada, and Australia, DoorDash is about connecting people with possibilities: bigger savings accounts, wider nets, (more...)
Company: Doordash
Location: Bosque Farms
Posted on: 01/24/2021

Are you tired of a dead end job?
Description: Growing 26 year old National Discount Health Benefits provider of healthcare access in the US is seeking bright, motivated people enjoy helping
Company: Living Healthy
Location: Corrales
Posted on: 01/24/2021

Albuquerque Organic Chemistry Tutor Jobs
Description: Albuquerque Organic Chemistry Tutor Jobs Varsity Tutors has students in Albuquerque looking for Organic Chemistry tutoring. Varsity Tutors is a live learning platform that connects tutors with students (more...)
Company: Varsity Tutors
Location: Albuquerque
Posted on: 01/24/2021

HSPT Tutor
Description: Job Description Albuquerque HSPT Tutor JobsVarsity Tutors is always looking for bright individuals in Albuquerque
Company: Varsity Tutors
Location: Albuquerque
Posted on: 01/24/2021

Log In or Create An Account

Get the latest New Mexico jobs by following @recnetNM on Twitter!

Albuquerque RSS job feeds