Clinical Quality Reviewer - REMOTE - RN - US Citizen Required

Clinical Quality Reviewer

• REMOTE
• RN•US Citizen Required TEEMA•4.

0 Phoenix, AZ Job Details Full-time $41

• $44 an hour 1 hour ago Qualifications Nursing RN License Writing skills RN experience Clinical documentation

Nursing Full Job Description Compensation:

$85,000

• $92,000

Hourly Equivalent:

~$41

• 44/hr

Location:

Remote Schedule:

Must work AZ hours (typically 1st shift)

CLIENT NOTES / EXPECTATIONS

Candidates must meet required AND preferred qualifications

APPROVED WORK STATES

(RECRUITING

GUIDELINES

)

AK, AR, AZ, CO, DC, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NC, ND, NE, NM, NV, OK, OR, SC, SD, TN, TX, UT, VA, WA, WI, WY

Only source candidates in these states

REQUIRED QUALIFICATIONS

(MUST HAVE) Active, unrestricted license: RN Minimum 3+ years clinical experience (med/surg and/or behavioral health) Strong clinical documentation + writing ability U.S. Citizenship required Must be eligible for DoD background clearance

PREFERRED QUALIFICATIONS

(HIGHLY DESIRED) Clinical Quality / Utilization Review / Case Review experience Experience with federal or government healthcare programs InterQual or similar clinical criteria tools Data analysis / reporting exposure Bachelor's degree in Nursing or healthcare-related field

CORE RESPONSIBILITIES

(WHAT

THEY ACTUALLY DO

) Review medical records for quality, safety, and utilization issues Identify Potential Quality Issues (PQIs) Write detailed case summaries + recommendations Support peer review + quality improvement initiatives Collaborate with Medical Directors Analyze trends and recommend improvements Ensure compliance with regulatory and program standards

IDEAL CANDIDATE PROFILE

Clinical reviewer / utilization review nurse Experience with health plans or large healthcare systems Experience in Med-Surg in a hospital environment Strong analytical + writing skills #Workwolf