Performs duties reviewing patient charts at contracted hospitals and clinics to determine if the quality and utilization of services are within established guidelines.
Possession of a valid State of
Five years of general medical or surgical nursing experience to include two years performing Quality Assurance, Utilization Review or Case Management duties; and
Possession of a valid Driver License.
Or an equivalent combination of education, training and experience that would reasonably be expected to provide the job-related competencies noted below.
JOB SPECIFIC COMPETENCIES
Note: The following duties are illustrative and not exhaustive. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. Depending on assigned area of responsibility, incumbents in the position may perform some or all of the activities described below.
CLASS: HCSVRNGENQ; EST: 4/21/1999; REV: 7/15/2011;