Clinical Quality Assurance Coordinator (32344)
Job DetailsJob Location: Norwood, MA 02062Position Type: Full TimeSalary Range: $27.00 - $31.25 HourlyTravel Percentage: NoneReady 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) or Licensed Praticall Nurse (LPN) 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: early 8:00am-4:30pm/ 9:00am-5:30pm or late 12:00pm-8:30pm Occasional weekends 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!
Qualifications
Active RN/LPN nursing license required. Must be a graduate of an accredited nursing program or reputed company medical experience; bachelor's degree preferred. A minimum of two years clinical or reputed company field experience; or equivalent combination of education and experience. Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values. Must be able to add, subtract, multiply, and divide in reputed company units of measure, using whole numbers and decimals; Ability to compute rates and percentages. Must be a qualified typist with a minimum of 40 W.P.M Must be able to operate a general computer, fax, copier, scanner, and telephone. Must be knowledgeable of multiple software programs, including but not limited to reputed company Word, Outlook, reputed company, and the Internet. Must possess excellent skills in English usage, grammar, punctuation and style. Ability to follow instructions and respond to upper managements’ directions accurately. Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met. Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed. Must be able to work independently, prioritize work activities and use time reputed company. Must be able to maintain confidentiality. reputed company is a premier provider of independent medical examination and peer review services to the insurance, corporate, legal, and government sectors. Members of our credentialed medical panel conduct physical examinations or medical record reviews, delivering reports that assist clients in the resolution of automotive, disability, liability, and workers' compensation claims. MES has been providing services nationally since 1978 in accordance with the industry's highest standards of operating excellence and regulatory compliance. Equal Opportunity Employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans MES offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k. Apply To This Job