Position Title: Nurse RN 3 (Clinical Quality Review)
Work Location: Remote in California
Assignment Duration: 12 months
Work Schedule: 08:00:AM - 05:00:PM
Work Arrangement: Remote

Summary: 

Monitors the quality of care provided to members through inquiry research resolution, internal case review and/or IPA/MG oversight activities.
May conduct comprehensive analysis of complaints, grievances and internal quality case reviews.
Coordinates all information, formulates resolution and responds to the appropriate parties.

Job Responsibilities: 

• Works under general supervision and able to function independently to produce results that meet standards of quality, timeliness and acceptability. 

• Makes decisions on routine matters where established policies and procedures are available. 

• Ability encompasses broad knowledge of concepts, practices and procedures required within health care field. 

• Uses concepts and abilities as well as internal policies and procedures to complete assignments and solve problems. 

Skills:
Verbal and written communication skills, multi-tasking, customer service skills and interpersonal skills.
Strong ability to work independently and manage one’s time.
Strong ability to keep information organized and confidential.

Education/Experience:
• Associate’s degree in nursing required. Bachelor’s degree preferred.
• Nursing license required.
• 5-7 years experience required.

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 45.00/hr.