QM Nurse Consultant - Richmond, VA
3 days ago

Job summary
The QM Nurse Consultant is responsible for conducting Quality Management Reviews (QMRs) and supporting Performance Improvement Projects (PIPs) to ensure Medicaid-funded services meet regulatory, clinical,and quality standards.
Responsibilities
- Conduct on-site and desk audits to ensure services comply with DMAS regulations... ,
- Analyze utilization trends and exception reports to identify outliers or inappropriate billing practices.
Job description
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