Remote Senior Nurse - Quality & Accreditation Lead

Wns; Houston (TX); A distancia; USD 80.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, and vision insurance

401(k) with company match

PTO, holidays, and sick leave

Descripción de la vacante

WNS, part of Capgemini, seeks a Senior Nurse - Quality and Accreditation to lead quality assurance activities ensuring adherence to client contracts, regulatory standards, and accreditation requirements. The role identifies trends early, conducts audits, and collaborates across departments to drive improvements.

RESPONSIBILITIES include auditing, root cause analysis, and contributing to Quality Improvement Projects; requires RN license and strong knowledge of CMS/URAC/NCQA standards.

Formación

• RN license active and unrestricted in a U.S. state.
• Graduate of an accredited school of nursing.
• Minimum 3 years in utilization management or equivalent.
• Minimum 1 year in quality or compliance auditing, QA, or similar.

Responsabilidades

• Perform quality audits of clinical review activities and ensure regulatory compliance.
• Provide quality scoring and trend analysis with root cause investigation.
• Support accreditation and regulatory audits with documentation and responses.
• Lead quality improvement projects and cross-department collaboration.
• Maintain knowledge of utilization management workflows and policies.

Conocimientos

Audit and process improvement

Root cause analysis

Regulatory knowledge

Independent work

Educación

RN license (US)

Nursing degree

Herramientas

MS Office (Excel)

Descripción del empleo

WNS, part of Capgemini, seeks a Senior Nurse - Quality and Accreditation to lead quality assurance activities ensuring adherence to client contracts, regulatory standards, and accreditation requirements. The role identifies trends early, conducts audits, and collaborates across departments to drive improvements.

RESPONSIBILITIES include auditing, root cause analysis, and contributing to Quality Improvement Projects; requires RN license and strong knowledge of CMS/URAC/NCQA standards.