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QA Nurse Specialist
Ref No.: 18-08393
Location: New York, New York
QA Nurse Specialist
New York, NY
Project/Position Introduction
The QA RN Specialist will support the Conflict Free Evaluation and Enrollment Center (CFEEC) project of NYMC.

The position is based out of lower Manhattan and may require some travel in NYC and the neighboring regions.

RN License required.
Overview
The LTCE segment of NYMC is to help people receive nursing home quality care in their homes. Nurse Assessors make determinations regarding whether a chronically ill person qualifies for in-home care using professional expertise and independent judgment. The QA Nurse Specialist reviews the Nurse Assessor's judgment using his or her own professional expertise. QA Nurse Monitoring Specialists also review assessment outcomes for completeness, accuracy, consistency, and outliers. This position attends Fair Hearing cases and prepares case packets. The QA Nurse Monitoring Specialist must, therefore, be a subject matter expert in the LTCE program and the nursing care field with proven good judgment skills.
Responsibilities
  • Review assessments to determine if the correct conclusion for eligibility of services was reached by the Nurse Assessor
  • Collect data related to assessments and assessment outcomes
  • Examine cases completeness, accuracy and consistency
  • Analyze UAS recommended scores in relation to Nurse Assessor determinations
  • Conducts scheduled home visits with the Nurse Assessor
  • Examines data for outliers and researches such cases
  • Develops / completes reports that track and trend activities / outcomes
  • Acts as an advisor to UAS staff on all QA and Compliance issues related to the UAS project.
  • Attend Fair Hearing cases and prepare case packets, as required
The Ideal Candidate will Possess the Following Additional Education and Experience
  • Bachelor's degree required
  • Preferred field of study: Healthcare, Social Services, or Communications
  • 2+ years RN experience in medical / surgical / geriatric / LTC / ambulatory care
  • Strong analytical skills
  • Detail and solution oriented
  • Ability to work independently
  • Excellent written and oral communication and presentation skills
  • Ability to use spreadsheet or database software
  • 2+ years previous work experience in Quality and Risk Management in a hospital setting conducting peer reviews
  • Bilingual: May be required in commonly spoken languages
  • RN License is required.