DescriptionThe Quality Management Nurse Specialist serves as the key resource for the investigation of member complaints, grievances, quality of care and access-related patient issues through collaboration with providers, health plans and other departments. The incumbent will conduct routine as well as ad hoc medical record and office site audits as required. As a member of the QM Team, this position assists with quality improvement studies through data collection, data input and report development. The QM Nurse Specialist will adhere to NCQA, State, Federal and other Regulatory agency standards. Additional areas of responsibility include tracking and trending complaint and grievance data to identify and r