Quality Review Nurse (RN)

Quality Review Nurse (RN) needed for a temp opportunity with Yoh’s client located in San Francisco, CA! WORK FROM HOME Top Skills Should You Possess:** - Recent Clinical Quality Review, NCQA and Auditing Experience required

What You’ll Be Doing: - Supports and lead clinical review activities within Quality department by providing clinical input and oversight for the following quality areas: grievance and appeals, potential quality issues, including provider preventable conditions, and clinical quality initiatives - Manage the review and resolution of Potential Quality Issues (PQIs) and other clinical quality related initiatives - Supporting initiatives within the Quality Improvement Plan including those related to HEDIS, CAHPS metrics and other California Department of Healthcare Services (DHCS) metric performance - Perform other duties as required

What You Need to Bring to the Table: - California Registered Nurse License – unrestricted - Recent Quality Review, NCQA and Auditing Experience - Two (2) Years of Managed Care or Health Plan experience; experience with Medi-Cal and/or Department of Health Care Services (DHCS) regulations and standards - Excellent interpersonal and communication skills - PC literacy and demonstrated proficiency with MS Office (Outlook, Word, Excel, PowerPoint)

_Any pay ranges displayed are estimations which may have been provided by job boards.   Actual pay is determined by an applicant's experience, technical expertise, and other qualifications as listed in the job description.  All qualified applicants are welcome to apply.

_ What’s In  It For You? We welcome you to be a part of the largest global staffing companies to meet your career aspirations. Yoh’s network of client companies has been employing professionals like you for over 65 years in the U.S., UK and Canada. Join Yoh’s extensive talent community that will provide you with access to Yoh’s vast network of opportunities. - Medical, Dental & Vision Benefits - 401K Retirement Saving Plan - Life & Disability Insurance - Direct Deposit & weekly EPayroll - Employee Discount Programs - Referral Bonus Programs

What are you waiting for?   Apply Now! Recruiter:  Annie Gill

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Note: Any pay ranges displayed are estimations.  Actual pay is determined by an applicant's experience, technical expertise, and other qualifications as listed in the job description.  All qualified applicants are welcome to apply.

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Visit  https://www.yoh.com/applicants-with-disabilities   to contact us if you are an individual with a disability and require accommodation in the application process.