Description

The Training Quality Manager is responsible for overseeing the quality of training programs and ensuring compliance with healthcare standards.

• Manage utilization management and medical necessity approval and denials.
• Handle a team of leaders, TLs, and Supervisors.
• Conduct training and quality management activities.
• Analyze complex medical information and identify relevant clinical issues.
• Prepare appeal arguments and communicate with stakeholders.
• Ensure familiarity with Medicare rules & regulations and guidelines.
• Work on-site with flexible schedules, including US hours and holidays.

Requirements

• Bachelor's Degree in Nursing with an active and valid license (PHRN/USRN).
• At least 2 years of experience in Utilization Management.
• Minimum 2 years in a managerial position.
• Experience in training and quality management.