Molina Healthcare has an immediate opening for an Advice Line QA Nurse. At Molina Healthcare, we believe every patient deserves access to quality care. Our Advice Line Nurses recognize the important role they play in providing this care.
Remote shifts available!Job Description Job Summary
Answers calls from numerous clients ranging from the general community to physician practice clients, managed care members, and Home Care patients. Performs health assessments using computerized guidelines. Provides general health information using approved references. May provide physician referrals and community service referrals as needed.
• Performs (at a minimum) monthly QA for Advice Nurses utilizing established indicators including call and chart monitoring
• Identifies quality issues and assists with developing plans of action to correct and resolve issues
• Provides timely documentation of QA results to both staff and management
• Member of Quality Improvement Committee; spearheads the quarterly meetings
• Identifies and actively participates in internal quality and work flow enhancement projects and
• Performs Complaint and Grievance intake, investigation and follow up per state mandated timeframe
• Monitors and maintains contractual agreements for URAC
• Assists in ensuring that all staff obtain licensure in all Molina state plans serviced and updates license grid
• Actively provides feedback and performance oversight to staff and assists with coaching
• Assists in maintaining personal files, performs audits and notifies staff of expiring credentials to ensure compliance
• Works collaboratively with the management team to provide orientation/training to new Advice Nurses
• Other duties as assigned including providing supervisory support as needed, as well as maintaining clinical on-call for after hours staff issues
• Position requires ability to work remotely 50% of the time
Shift - 4 10.5-hour shifts per week, 10 am shift start time Job Qualifications Required Education
Associate's Degree or equivalent combination of education and experience.
3 years minimum of acute care experience, along with minimum 1 year of Telephonic Triage experience.
Required License, Certification, Association
R.N. with active unrestricted California license and current BLS Certification.
Bachelor's Degree or equivalent combination of education and experience.
5+ years of acute care experience and 1+ years of Telephonic Triage experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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