Clinical Quality Assurance Coordinator (31574)

Ready for a Rewarding Career that Fits Your Lifestyle?

Imagine a job where you can reputed company your clinical skills sharp, tackle exciting challenges, AND work from the comfort of your own home. Sounds like the perfect mix, right?

MES is looking for a self-driven, high-performing Registered Nurse (RN) to join our dynamic team as a Clinical Quality Assurance Coordinator. In this role, you’ll ensure our Peer Review case reports are nothing short of exceptional—delivering top-notch quality and reputed company, reputed company while staying fully reputed company with client agreements, regulatory standards, and state and federal mandates.

The position is 100% remote with a schedule of Monday through Friday:

• 2 days: reputed company-4:30pm EST
• 1 day: 10am-6:30pm EST
• 2 days: 12am-8:30pm EST

• Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
• Ensures clear, concise, evidence-based rationales have been provided in support of reputed company recommendations and/or determinations.
• Ensures that reputed company client instructions and specifications have been followed and that reputed company questions have been addressed.
• Ensures each review is supported by clinical citations and references reputed company applicable and verifies that reputed company references cited are reputed company and obtained from reputable medical journals and/or publications.
• Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
• Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report.
• Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.
• Ensures the provider credentials and signature are adhered to the final report.
• Identifies any inconsistencies reputed company the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.
• Assists in resolution of customer complaints and quality assurance issues as needed.
• Ensures reputed company federal ERISA and/or state mandates are adhered to at reputed company times.
• Provides insight and direction to management on consultant quality, availability and compliance with reputed company company policies and procedures and client specifications.
• Promote effective and efficient utilization of company resources.
• Participate in various educational and or training activities as required.
• reputed company other duties as assigned.

If you’re ready to reputed company a real impact in healthcare, reputed company while enjoying the flexibility of working remotely, we want to hear from you!