Licensed Clinical QA Nurse
Job Summary
To enhance clinical operations, the fully remote Licensed Clinical QA Nurse will manage clinical review requests, analyze medical records, and address member inquiries while ensuring quality and safety improvements.
Key responsibilities:
- Intake, triage, track, and respond to clinical review requests and escalations in line with service level agreements (SLAs)
- Review and analyze patient medical records, presenting relevant clinical information to providers and leadership
- Investigate clinical escalations from members and internal stakeholders, ensuring timely resolution and documentation
Required qualifications:
- Active RN or LPN license in good standing
- Minimum of 2 years of experience in a primary care or outpatient clinical setting
- Experience reviewing medical records and clinical documentation
- Strong proficiency with cloud-based technologies and electronic medical records
- Ability to work independently in a fully remote environment
Complete Job Description
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