Do you Thrive in a Fast-Paced environment doing Clinical Quality Review of Medical Records to ensure high quality care is delivered? Do you enjoy identifying PQIs through research and investigation while preparing case summaries and developing peer review cases? If YES, consider joining a GROWING company that is a leader in their industry as a Contract Clinical Quality Reviewer!

Why this Company?

• Stable Company in business for over 20 years
• Work for an Award-Winning Organization
• Mission to serve others in the community

Why this Position?

• 6-Month Duration Contract
• Remote work opportunity
• Company is hiring multiple candidates due to needed project work
• Ability to make an impact & assist with this project need

The Fully Remote, Contract Clinical Quality Reviewer will identify, investigate and evaluate medical records for potential quality, safety, and utilization issues by using national and organizational standards for consistency to ensure quality care is delivered. Additionally, you will prepare case summaries with appropriate recommendations for further actions and develop peer review cases and other quality improvement activities for monitoring deviations from accepted standards of care and suggesting corrective action plans. You will refer cases for focused reviews to Leadership and participate on quality committees.

Full-time W2 Contract | Duration: 6 months

Hours: M-F | AZ Time Zone | 8:00 AM-5:00 PM

Location: Fully remote from select states ONLY: (AK, AZ, AR, CO, HI, IA, ID, IL, IA, KS, LA, MN, MO, MT, NE, NV, NM, ND, OK, OR, SD, TX, UT, WA, WI & WY)

Pay Rate: $40.86-$44.23 Per Hour 

EDUCATION & EXPERIENCE

REQUIRED

• High School Diploma
• Registered Nurse or Licensed Social Worker – with current unrestricted license in state you are located in
• 3+ years’ Clinical experience (Medical/Surgical and/or Behavioral Health)
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• Experience working in a fast-paced high-intensity environment
• Ability & Willingness to commit to Regular & Reliable Attendance
• Exceptional Communication & Customer Service Skills and a Team-Player who brings an "Always ready to help" attitude
• Strong Organizational & Analytical/Problem-Solving Skills
• Good Technical skills & Experience with Medical Management Systems with the ability to work in multiple software programs at one time
• Proficiency with MS Office (Outlook, Word, Excel)
• Must be a U.S. Citizen + Complete a Favorable DoD background investigation

PREFERRED

• Bachelor's in Nursing or Bachelor’s degree in a health care field or Certified Professional in Healthcare Quality (CPHQ)
• 1 year experience in Clinical Quality Management
• 1 year experience with data analysis and reporting
• Experience with InterQual criteria or similar criteria sets
• General knowledge of Medicare, TRICARE, or other government healthcare programs

For IMMEDIATE consideration APPLY and/or email your resume to cathy@the-finders.com