Clinical Quality Assurance Coordinator

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

📋 Description

• Ensure that Peer Review case reports maintain the highest quality and integrity, adhering to client agreements and regulatory standards.

• Conduct quality assurance reviews of peer review reports, correspondences, addendums, or supplemental reviews.

• Provide clear, concise, and evidence-based rationales to support all recommendations and/or determinations.

• Confirm that all client instructions and specifications have been adhered to and that all inquiries have been addressed.

• Ensure each review is accompanied by relevant clinical citations and references where applicable.

• Maintain compliance with company standards regarding the content, format, and professional presentation of reports.

• Accurately document on the case report in accordance with specifications and mandates.

• Reach out to the Peer Reviewer for clarification, modifications, or corrections as necessary to resolve inconsistencies within the report.

• Assist in addressing customer complaints and quality assurance issues as required.

⛳️ Requirements

• An active RN nursing license is required.

• Must be a graduate of an accredited nursing program or have related medical experience; a bachelor's degree is preferred.

• A minimum of two years of clinical or related field experience, or an equivalent combination of education and experience.

• Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values is essential.

• Proficiency in basic arithmetic operations, including addition, subtraction, multiplication, and division with whole numbers and decimals; ability to calculate rates and percentages.

• Must be a qualified typist with a minimum typing speed of 40 words per minute.

• Capable of operating general office equipment such as computers, fax machines, copiers, scanners, and telephones.

• Familiarity with multiple software applications, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.

• Excellent command of English usage, grammar, punctuation, and writing style is required.

• Ability to follow instructions and accurately respond to directions from upper management.

• Demonstrates accuracy and thoroughness, actively seeking ways to enhance quality and monitoring one's own work to ensure standards are met.

• Must exhibit exceptional communication skills, effectively conveying information, listening attentively, and asking questions for clarification when necessary.

• Ability to work independently, prioritize tasks, and manage time efficiently.

• Must be able to maintain confidentiality at all times.

🏝️ Benefits

• Medical insurance

• Vision

• Dental

• Paid time off

• 401k