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Quality Management Nurse - Remote Or Hybrid
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- Quality Management Nurse - Remote or Hybrid - 24-29 page is loaded
- Quality Management Nurse - Remote or Hybrid - 24-29
- The Utilization Management Quality Management (UMQM) Nurse position is meant to ensure the quality of the work of the individuals in the Prior Authorization Department.
- The UMQM Nurse shall also participate in Utilization Management related activities with the Appeals and Grievance Department as well as the Compliance Department to assure that the quality compliance is being met for NCQA, state and federal regulatory requirements.
- Monitors the UM standards compatible with health plans, NCQA, state and federal regulatory requirements, and health plan delegation changes by conducting established monitoring audits to both clinical and non-clinical authorization requests.
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