Director of Quality Assurance (1101005)

SUPPLEMENTAL QUESTIONNAIRE
Director of Quality Assurance (1101005)
Applicant Name: / Date:
Supplemental questions are used to assist us in the evaluation of your application for interview purposes. By answering these questions, you help to reduce the amount of interpretation involved.
Please complete the questionnaire and attach to a completed application.
Position Requirements / Select the options below that best describe your education and experience. (Double click boxes to check)
I have:
I have a Bachelor’s Degree.
I am a Registered Nurse (Current/Valid license).
I have 7 years of professional experience in statistical, research work, quality assurance, compliance, or health care administration (Experience includes 3 years of supervisory experience).
I have a Master’s Degree that may count towards 2 years of experience.
OR:
I do not meet any of the requirements as described.
Information Requested / Please provide the following information
Degree: / Date Completed:
Please list the position(s) where you obtained the related work experience;
1)
2)
3)
Total experience: / Years / Months
Position Preferences / Check all that apply and indicate where you obtained the experience
I HAVE: / (Double click boxes to check)
SoonerCare experience.
Place and dates where you obtained the experience:
Health insurance work experience.
Place and dates where you obtained the experience:
Coding knowledge (CPT, HCPCS, ICD-9-CM, DRG).
Place and dates where you obtained the experience:
Contract administration experience.
Place and dates where you obtained the experience:
5 years of supervisory experience.
Place and dates where you obtained the experience:
Advanced Education in Health Administration, Business Administration, Public, Administration, Social Sciences (Education includes nine (9) semester hours of advanced statistical methods).
Degree: / Date: