Facility Site Review Nurse

Facility Site Review Nurse University of California, Los Angeles, United States 40 minutes ago

Location:

Los Angeles, CALIFORNIA JOB DUTIES Description The Facility Site Review (FSR) Nurse is responsible for planning, coordinating, and overseeing Facility Site Reviews and Medical Records Reviews for the UCLA Medical Group provider network. This role supports compliance with healthcare standards, regulatory requirements, and health plan contractual obligations while promoting audit readiness and continuous quality improvement. The Facility Site Review Nurse serves as a key liaison between provider sites, clinic leadership, office staff, contracted health plans, and other stakeholders to ensure compliance and support performance improvement initiatives. Key Responsibilities Coordinate and oversee Facility Site Reviews and Medical Records Reviews for provider sites. Ensure clinics are prepared for audits and meet health plan and regulatory requirements. Provide guidance and support to provider sites throughout the audit process. Track audit results, corrective action plans, and compliance activities. Identify areas for improvement and assist sites with resolving audit findings. Communicate audit results and follow-up actions to provider sites and stakeholders. Educate provider sites on audit requirements, standards, and expectations. Conduct virtual and on-site readiness reviews and mock audits. Collaborate with health plans and internal teams to support quality improvement efforts. Support HEDIS, Pay for Performance activities, administer Provider Access and Availability Surveys (PAAS), and other quality management activities.

Salary Range:

$37.60 - $78.35/hourly

JOB QUALIFICATIONS

Qualifications All items listed below are required: Current LVN or RN licensure in the state of California required. If providing RN licensure, a BSN or MSN is required. Four years or more of combined clinical nursing experience, including direct patient care and quality management, with proven expertise in FSR/MRR standards. High school diploma required Solid understanding of managed care principles and healthcare standards. Experience navigating and reviewing electronic medical records. Skilled in ing, analyzing, and interpreting quantitative and qualitative data. Clear and effective communication and problem-solving skills. Proficient computer skills in Microsoft Outlook, Word, Excel, and Teams. Direct experience in facilitating virtual meetings utilizing video conferencing platforms (i.e., Zoom, MS Teams, Webex). Able to express ideas and information concisely and professionally, both in writing and verbally. Foster strong, professional relationships with provider site teams that promote trust, collaboration, and continuous engagement. Interpret and communicate regulatory updates in a timely and concise manner, ensuring provider site teams understand changes in standards. Attend relevant meetings to present materials to inform, educate, and support staff on audit findings, best practices, and process improvements. Participate and actively engage in Quality Management (QM) meetings to report on the status and outcomes of FSR/MRR audits promptly following up on action items.

Preferred:

Bachelor's degree preferred Certified Master Trainer (CMT) preferred Basic Life Support (BLS) from American Heart Association, or American Red Cross preferred