Top 41 Quality improvement nurse Jobs in Fort Smith, Ar

Clinical Services Specialist RN
AFMC —Fort Smith, AR
- Full-time
- Nursing
- Microsoft Outlook
- RN License
AM Registered Nurse III
The State of Oklahoma —Sequoyah County, OK
- $40 an hour
- Full-time
- Nursing
- Addiction Medicine
- RN License
Outreach Specialist RN IOC
AFMC —Fort Smith, AR
- Full-time
- Nursing
- Microsoft Outlook
- RN License
APRN/PA - Post-Acute and Long-Term Care - Advanced Practitioner
Appello Health and Wellness —Charleston, AR
- Full-time
- Nursing
- Skilled nursing facility
- Ability to walk for extended periods
- Health savings account
- Health insurance
Quick Apply
APRN/PA - Post-Acute and Long-Term Care - Advanced Practitioner
Appello Health and Wellness —Van Buren, AR
- Full-time
- Nursing
- Skilled nursing facility
- Ability to walk for extended periods
- Health savings account
- Health insurance
Quick Apply
APRN/PA - Post-Acute and Long-Term Care - Advanced Practitioner
Appello Health and Wellness —Greenwood, AR
- Full-time
- Nursing
- Skilled nursing facility
- Ability to walk for extended periods
- Health savings account
- Health insurance
Quick Apply
PRN Nurse
Springs of Covington —Fort Smith, AR
- Part-time
- RN License
- LPN
- 1 year
Quick Apply
13d
LPN IV -Wound Care
The State of Oklahoma —Sequoyah County, OK
- $33 an hour
- Full-time
- Mid-level
- 3 years
- Ability to lift 50 pounds
11h
PM Registered Nurse III
The State of Oklahoma —Sequoyah County, OK
- $40 an hour
- Full-time
- Nursing
- Addiction Medicine
- RN License
Certified Scrub Tech Surgery - Full Time SMH
NORTHEASTERN HEALTH SYSTEM —Sallisaw, OK
- Full-time
- Surgery
- BLS Certification
- Mid-level
- On-the-job training
Quick Apply
13d
Staff Psychiatric Mental Health Nurse Practitioner (PMHNP) — Remote | Telehealth | Full-Time or Part-Time | Arkansas
Legion Health —Fort Smith, AR
- $150,000 - $300,000 a year
- Choose your own hours
- Remote
- Psychiatry
- Mid-level
- Outpatient experience
- Work from home
1d
RN Nursing Manager I - MDS
The State of Oklahoma —Sequoyah County, OK
- $43 an hour
- Full-time
- Nursing
- RN License
- Writing skills
12d
Palliative Care Nurse Practitioner
Optum —Fort Smith, AR
- $104,500 - $156,000 a year
- Full-time
- CPR Certification
- BLS Certification
- Pass drug screening
Quick Apply
14d
Part Time Dietitian
Morrison Healthcare —Fort Smith, AR
- Part-time
- Acute care
- Hospital
- Inpatient
- Paid time off
- Opportunities for advancement
Quick Apply
Advanced Practice Provider
Urologic Specialists of Oklahoma Inc —Fort Smith, AR
- Weekends as needed
- CPR Certification
- Nursing
- RN License
Quick Apply
Pharmacist, Inpatient Rehabilitation, PRN
Mercy Rehabilitation Hospital - Fort Smith —Fort Smith, AR
- Part-time
- Hospital
- Bachelor of Science
- Inpatient
- Tuition reimbursement
- 401(k) matching
Quick Apply
13d
RN Clinical Supervisor - NICU
Mercy —Fort Smith, AR
- Full-time
- Nursing
- RN License
- BLS Certification
- Health insurance
- Dental insurance
Pharmacy Technician / Pharm Tech Apprenticeship
Walgreens —Van Buren, AR
- $16.50 - $20.00 an hour
- Weekends as needed
- Computer literacy
- English
- Fair chance
- Health insurance
- Dental insurance
Collaborating Psychiatrist / Supervising Physician (MD or DO) — Remote | Telehealth | Part-Time | Arkansas
Legion Health —Fort Smith, AR
- $50,000 - $150,000 a year
- Choose your own hours
- Remote
- Medicine
- Management
- Psychiatry
- Work from home
1d
Registered Nurse - Home Health
Mercy —Fort Smith, AR
- Weekends as needed
- CPR Certification
- Nursing
- RN License
- Health insurance
- Dental insurance

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Clinical Services Specialist RN

AFMC -
Fort Smith, AR

Apply Now

Job Details

Full-time

Qualifications

Customer communication
Employee relationship building
English
Patient care

Full Job Description

Job Description:

SCOPE OF POSITION:
Responsible for analyzing patient records to determine legitimacy and necessity of medical services in compliance with government reimbursement policies. Review may be prior authorization, concurrent with service or post service. Review findings may be referred to a physician advisor for final determination. Support the organization’s mission, vision, and values by exhibiting the following behaviors: Honesty, Excellence, Accountability, Respect and Teamwork.

ESSENTIAL JOB FUNCTIONS:
1. Review each selected record accurately and according to AFMC, state and federal policies and procedures.
2. Function as a resource for non-clinical staff by providing oversight and follow-up for clinical related questions or issues
3. Write effective and accurate review summaries and submit within appropriate time frame.
4. Refer all cases that do not meet established medical necessity criteria for approval to a peer clinical reviewer on a daily basis.
5. Maintain files for recording and reporting in accordance with established procedures.
6. Perform site surveys as required or directed if relevant to your department. Must be able to travel within the State as needed to accomplish required site visits if relevant to your department.
7. Prepare monthly reports and/or statistics as directed.
8. Communicate effectively with internal and external clients. Upon request, verbally informs patients, facility personnel, the attending physician and other ordering providers, and health professionals of specific utilization management requirements and procedures
9. Seek direction from Manager Clinical Services, Director Clinical Services, Associate Medical Director, or Medical Director for any clinical related questions or issues during the review process.
10. Daily quotas may be added to meet contract deliverables as needed.
11. Adhere to format, content, and style guidelines, giving consideration to usability and ensuring accuracy, consistency, and quality.
12. Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance.
13. Additional duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES:

Intermediate level computer skills (Excel, Word, Access, PowerPoint, and Outlook).
Type 40 wpm.
Exceptional skills in business English and spelling are required.
Ability to maintain confidentiality.
Strong oral and written communication skills.
Creativity.
Customer service.
Ability to meet deadlines.
Attention to detail.
Flexibility.
Knowledge of ICD 9/ICD 10 Coding.
Knowledge of HIT/EHR.
Medical terminology.
Ability to work collaboratively and independently to achieve stated goals.
Initiative.
Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients, and the public.
Ability to multitask.
Ability to prioritize.
Strong organizational skills.
Problem solving skills.
Professionalism.
Project management skills.
Ability to read, interpret and apply laws, rules, and regulations.
Knowledge of quality improvement processes and techniques.
Time management skills.
Ability to travel, including overnight travel.

Physical and Sensory Requirements (With or Without the Aid of Mechanical Devices):
Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress. Must be able to lift and transport 25 pounds. Must be capable of performing the essential job functions of this job, with or without reasonable accommodations.

EDUCATION:
Required: Diploma or Associate’s degree in nursing, licensed as a Registered Nurse in the state of Arkansas without restrictions or licensed as a multistate Registered Nurse and can practice in the state of Arkansas.
Desirable: Bachelor’s degree in nursing

EXPERIENCE:
Required: Three (3) years clinical nursing experience
Desirable: Quality Assurance / Utilization Review and/or coding experience, QIO experience

INTERNET REQUIREMENTS:
Reliable, high-speed wireless internet service (Wi-Fi)

Apply Now

Refine Your Search

quality improvement nurse jobs in fort smith, ar

Clinical Services Specialist RN

AM Registered Nurse III

Outreach Specialist RN IOC

APRN/PA - Post-Acute and Long-Term Care - Advanced Practitioner

APRN/PA - Post-Acute and Long-Term Care - Advanced Practitioner

APRN/PA - Post-Acute and Long-Term Care - Advanced Practitioner

PRN Nurse

LPN IV -Wound Care

PM Registered Nurse III

Certified Scrub Tech Surgery - Full Time SMH

Staff Psychiatric Mental Health Nurse Practitioner (PMHNP) — Remote | Telehealth | Full-Time or Part-Time | Arkansas

RN Nursing Manager I - MDS

Palliative Care Nurse Practitioner

Part Time Dietitian

Advanced Practice Provider

Pharmacist, Inpatient Rehabilitation, PRN

RN Clinical Supervisor - NICU

Pharmacy Technician / Pharm Tech Apprenticeship

Collaborating Psychiatrist / Supervising Physician (MD or DO) — Remote | Telehealth | Part-Time | Arkansas

Registered Nurse - Home Health

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