Clinical Quality Reviewer - REMOTE - RN - US Citizen Required

TEEMA; Phoenix (AZ); Remote; USD 85,000 - 92,000; Full time

Job summary

TEEMA is seeking an RN with 3+ years of clinical experience for a remote role in the United States. The position emphasizes medical record review, quality assurance, and collaboration with medical leadership.

The role requires strong documentation skills, eligibility for DoD background clearances, and experience with health plans or large healthcare systems. Remote work suits AZ hours with first-shift alignment.

Qualifications

• Active, unrestricted RN license.
• Minimum 3+ years clinical experience (medical/surgical and/or behavioral health).
• Strong clinical documentation and writing ability.
• Must be eligible for DoD background clearance.

Responsibilities

• Review medical records for quality, safety, and utilization issues.
• Identify Potential Quality Issues (PQIs).
• Support peer review and quality improvement initiatives.
• Collaborate with Medical Directors to drive standards.
• Analyze trends and recommend improvements.
• Ensure compliance with regulatory and program standards.

Skills

Clinical documentation

Medical record review

Regulatory compliance

Education

RN license

Bachelor’s degree in nursing or healthcare field

Tools

InterQual

Data analysis tools

Job description

Compensation: $85,000 – $92,000
Hourly Equivalent: ~$41–$44/hr

Location: Remote
Schedule: Must work AZ hours (typically 1st shift)

CLIENT NOTES / EXPECTATIONS

Candidates must meet required AND preferred qualifications

APPROVED WORK STATES (RECRUITING GUIDELINES)

AK, AR, AZ, CO, DC, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NC, ND, NE, NM, NV, OK, OR, SC, SD, TN, TX, UT, VA, WA, WI, WY

Only source candidates in these states

REQUIRED QUALIFICATIONS (MUST HAVE)

Active, unrestricted license:

RN

Minimum 3+ years clinical experience
(med/surg and/or behavioral health)

Strong clinical documentation + writing ability

Must be eligible for DoD background clearance

PREFERRED QUALIFICATIONS (HIGHLY DESIRED)

Clinical Quality / Utilization Review / Case Review experience

Experience with federal or government healthcare programs

InterQual or similar clinical criteria tools

Data analysis / reporting exposure

Bachelor’s degree in Nursing or healthcare-related field

CORE RESPONSIBILITIES (WHAT THEY ACTUALLY DO)

Review medical records for quality, safety, and utilization issues

Identify Potential Quality Issues (PQIs)

Support peer review + quality improvement initiatives

Collaborate with Medical Directors

Analyze trends and recommend improvements

Ensure compliance with regulatory and program standards

IDEAL CANDIDATE PROFILE

Experience with health plans or large healthcare systems

Experience in Med-Surg in a hospital environment