Pennsylvania Licensed Quality Reviewer

Job Summary

Seeking a Pennsylvania Licensed Quality Reviewer, the hybrid/remote position will conduct clinical reviews and audits of case management and provider treatment records, ensuring compliance with quality standards and regulations while residing near the Blair County area.

Key responsibilities

• Conduct audits and reviews of clinical documentation and interactions against established regulations and standards
• Prepare and present monthly performance reports, analyzing clinical record information for quality improvement projects
• Evaluate patient safety risks and assist in implementing activities to enhance service delivery and quality of care

Required qualifications

• Bachelor's degree in Nursing or a master's degree in Behavioral Health required
• 5+ years of clinical experience required; 7+ years of clinical experience may substitute for educational requirements
• Experience in total quality improvement or behavioral healthcare treatment modalities
• Ability to work independently with minimal supervision
• Project management skills and demonstrated experience required