Teams at IPRO

Coordinates external quality review activities and healthcare quality improvement projects for Medicaid agency clients. Manages project timelines, multidisciplinary teams, subcontractors, data collection, analysis, reporting, and client deliverables. Prepares technical reports, work plans, proposals, presentations, and recommendations. Supports recruitment, training, supervision, process improvement, and stakeholder communication while ensuring accurate and timely outcomes.

Leads healthcare quality improvement initiatives across hospitals, nursing homes, clinics, and physician offices. Educates provider staff, conducts onsite visits, develops interventions, monitors progress, evaluates performance, provides consulting, coordinates assessments, mentors staff, and presents project results. Collaborates with data analysts on performance reports and travels to healthcare sites throughout New York State.

Conduct utilization, quality, clinical study, and appeal-level reviews using medical records and electronic worksheets. Make level-one denial decisions, collect clinical data, support Medical Review Analysts and Physician Consultants, and assist administrative staff with training, problem-solving, procedures, technical guidance, and staff huddles. The role requires a New York State RN license, nursing education, and acute-care or utilization-review experience.