Clinical Quality Assurance Analyst

Staffmark Group; Nashville (TN); Remote; USD 67,000 - 73,000; Full time

Benefits offered by this job

Competitive Weekly Pay

Medical, Dental, Vision Coverage

Life Insurance & Disability Insurance

Optional 401(k) Plan

Growth opportunities

Job summary

Staffmark Group in Nashville, TN is seeking a Clinical Quality Assurance Analyst to perform chart reviews, audits, and data validation to uphold accuracy and compliance. You will monitor quality metrics, generate reports for leadership, and support enterprise quality initiatives in a remote-capable environment.

The role requires 5+ years in clinical healthcare or auditing, plus 4+ years in healthcare quality improvement; knowledge of Medicare/Medicaid and HIPAA is essential.

Qualifications

• Bachelor's degree preferred; equivalent healthcare, clinical, or auditing experience will be considered.
• Relevant coding certifications, healthcare auditing credentials, or quality management experience are a plus.
• Strong computer proficiency, including Microsoft Excel (sorting, filtering, and data analysis).

Responsibilities

• Conduct clinical chart reviews, audits, and clinical data validation to ensure accuracy and compliance.
• Monitor quality metrics and maintain reporting tools that support healthcare quality initiatives.
• Analyze audit findings and prepare reports for leadership and key stakeholders.
• Support company-wide quality improvement programs and clinical auditing processes.
• Ensure compliance with contractual, state, federal, and healthcare quality standards.
• Assist with clinical product implementation, project timelines, and process improvement initiatives.
• Develop and deliver training programs for clinical review and auditing personnel.
• Collaborate with cross-functional teams to support quality management services and client relationships.
• Research industry trends, competitive benchmarks, and healthcare quality opportunities.
• Recommend process improvements and document procedural enhancements.
• Maintain compliance with HIPAA regulations and company policies.

Skills

Quality Assurance

Clinical Auditing

Data Analysis

HIPAA Compliance

Healthcare Knowledge

Remote Work

Education

Bachelor's degree preferred

Healthcare auditing credentials

Microsoft Excel proficiency

Tools

Microsoft Excel

Job description

Now hiring for a Clinical Quality Assurance Analyst

Location: Nashville, TN

Pay Rate: $32.00 - $35.00 per hour

Schedule: M-F 9a-5p

Pros wanted. This is your kind of job.

Looking for Clinical Quality Assurance Analyst jobs in Nashville where your skills can make a real impact? This opportunity offers the chance to contribute to a growing team, develop your experience, and build a rewarding career in a professional work environment.

If your skills and experience are a good match for this role. This opportunity is being offered by Staffmark to qualified candidates.

Job Duties

• Conduct clinical chart reviews, audits, and clinical data validation to ensure accuracy and compliance.
• Monitor quality metrics and maintain reporting tools that support healthcare quality initiatives.
• Analyze audit findings and prepare reports for leadership and key stakeholders.
• Support company-wide quality improvement programs and clinical auditing processes.
• Ensure compliance with contractual, state, federal, and healthcare quality standards.
• Assist with clinical product implementation, project timelines, and process improvement initiatives.
• Develop and deliver training programs for clinical review and auditing personnel.
• Collaborate with cross-functional teams to support quality management services and client relationships.
• Research industry trends, competitive benchmarks, and healthcare quality opportunities.
• Recommend process improvements and document procedural enhancements.
• Maintain compliance with HIPAA regulations and company policies.

Education Requirements

• Bachelor's degree preferred; equivalent healthcare, clinical, or auditing experience will be considered.
• Relevant coding certifications, healthcare auditing credentials, or quality management experience are a plus.
• Strong computer proficiency, including Microsoft Excel (sorting, filtering, and data analysis).

Experience Requirements

• Minimum 5 years of clinical healthcare experience, nursing experience, or hands-on healthcare auditing experience.
• At least 4 years of healthcare quality improvement, health plan, or managed care experience.
• Knowledge of Medicare, Medicaid, commercial insurance, and healthcare compliance standards.
• Strong analytical, organizational, communication, and problem-solving skills.
• Ability to work independently, manage multiple priorities, and learn new systems in a remote environment.
• Experience with clinical chart reviews, clinical data auditing, quality reporting, and process improvement preferred.

Physical Capabilities

• Ability to work remotely and remain productive in a home-office environment.
• Extensive computer use, including reviewing clinical records, reports, and audit documentation.
• Ability to attend virtual meetings and collaborate with cross-functional teams.
• Must maintain HIPAA compliance and confidentiality when handling sensitive healthcare information.

Benefits

• Competitive Weekly Pay
• Comprehensive Benefits including medical, dental, and vision coverage.
• Life Insurance and Disability Insurance for added peace of mind.
• Optional 401(k) Plan to help you prepare for the future.
• Opportunities for Growth through a variety of assignments with leading employers.

About Us

At Staffmark, we connect hardworking people with great companies, creating opportunities that make a lasting impact.

Staffmark is an equal opportunity employer. All applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other legally protected status. Staffmark offers reasonable accommodations for qualified individuals with disabilities; contact your local branch for inquiries. Staffmark is an E-Verify employer. See our Privacy Notice for Candidates and Employees/Contractors at https://smgroupna.com/privacy-notice-for-candidates-and-employees-contractors. By applying, you consent to receive AI-generated and non-AI-generated calls, texts, or emails from Staffmark Group, its affiliates, and partners. Frequency varies and message/data rates may apply. Reply STOP to cancel or HELP for help.