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Key Responsibilities:
- Conduct quality assurance audits on prospective, concurrent, and retrospective UM reviews.
- Analyze operational data and prepare reports with recommendations.
- Support root cause analysis and corrective actions.
Qualifications:
- Bachelor's degree in Healthcare Administration, Nursing, or related field preferred.
- Minimum 2 years experience in U.S. Healthcare, UM, or managed care.
- USRN License required.
Skills and Knowledge:
- Strong analytical and problem-solving capabilities.
- Advanced proficiency in Microsoft Office applications.
- Excellent verbal and written communication skills.
HealthEdge
HealthEdge provides AI-powered operational infrastructure for health insurance companies to help them compete effectively. The company is experiencing strong growth and is investing in its people to shape the future of healthcare technology.