Remote Quality of Care Nurse Reviewer

Location: California

Compensation: To Be Discussed

Staff Reviewed: Fri, Jan 14, 2022

This job expires in: 16 days

Job Category: Quality Assurance

Remote Level: 100% Remote

Employer Type: Employer

Career Level: Experienced

Education Level: Some College

Job Summary

A health insurance company is in need of a Remote Quality of Care Nurse Reviewer.

Core Responsibilities Include:

  • Leading quality issues investigations from start to resolution including review of clinical records
  • Working with the Medical Director/s to review and resolve confirmed quality of care issues
  • Working with providers, members, and internal service team to obtain necessary information and communicate findings

Required Skills:

  • Associates degree in Nursing
  • Active, unrestricted California Registered Nurse license and can obtain additional state licenses
  • 3 + years of experience working as a Registered Nurse in the healthcare setting (preferably managed care or insurance)
  • Experience evaluating clinical information and auditing medical records

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