Clinical QA Supervisor

This is a fully remote position, open to applicants in Florida.

📋 Description

• Supervision of the evaluation of Physician reports and related medical records to verify completeness, accuracy, and alignment with medical evidence.

• Ensure that the appropriate QA personnel are designated for each file and oversee their activities.

• Oversee the File Review Board to guarantee timely and precise processing of files.

• Assist in recognizing and addressing staff performance issues, including promotions, disciplinary actions, coaching, and terminations.

• Ensure that all QA personnel comply with their job responsibilities.

• Engage actively in resolving issues with QA, physicians, account managers, and other relevant parties.

• Serve as the point of contact regarding the procedures or status of the file.

• Other responsibilities and special projects as assigned.

⛳️ Requirements

• An Associate’s Degree or Bachelor’s Degree is preferred.

• RN licensure is required.

• Knowledge of medical peer review or the healthcare industry is necessary.

• Experience in a healthcare and/or insurance environment is preferred.

• Outstanding communication skills with a solid grasp of company business lines.

• Ability to utilize critical thinking, manage time effectively, and meet established deadlines.

• Proficiency in computer use and typing skills are essential.

🏝️ Benefits

• Medical, dental, and vision coverage for you and your family.

• Voluntary life insurance options for you, your spouse, and your children.

• Additional voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance plans.

• Basic life insurance, short-term disability, and long-term disability coverage provided at no cost.

• Generous paid time off policy.

• 401k plan with company matching contributions.

• Apple equipment and a media stipend for remote workspace.