Registered Nurse III

We are hiring Registered Nurse III for one of our clients in Hamilton, NJ.

Job Description:

The Office of Quality Assurance (OQA) is requesting to hire temp staff to address the five openings (soon to be six) within the office. The individual hired to support the work of OQA should be a registered nurse.

• Gain understanding of Medicaid
• Gain understanding of the Managed Care Contract
• Address member care concern inquiries serve as a liaison to the MCO and will involve telephone contact with member/member representative, emails/telephone calls with MCOs, lookups in Medicaid databases, data entry into OQA tracking database on a daily basis. Initial outreach expected to member/MCO immediately upon receipt of call, ongoing follow-up with MCO expected every 48 hours until case closure.
• Answer office phones, as necessary
• Review MCO marketing material for clinical accuracy, provide email communication with requested edits to OQA supervisors
• Review MCO member manuals for clinical accuracy, provide email communication with requested edits to OQA supervisors
• Additional training in OQA activities of grievances/appeals reporting, childhood lead program, external quality review, and member transitions to be provided.
• Once knowledge set is attained, may support this work of the office.

Work hours:

• 08:30 am - 04:30 pm
• Lunch Duration:1 hr, unpaid

About Us:

We are specialized in recruiting and deliver the best professional talent of industry and we are committed to deliver best experience for our clients and job seekers. With over two decades of experience in the recruitment industry, we proudly help you to find the next job that matches your professional skills. Our team understands your needs or requirement before starting the recruitment, that enables to find the high quality of talent with high success rate of talent delivery, keeps us continue to be the best in the industry. By responding to this job posting, you are consenting to receive text/SMS messages from us. Thank you.