Clinical Quality Reviewer (RN/LCSW) - Remote

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

Job summary

TEEMA is partnering with a leading organization to recruit a Clinical Quality Reviewer (RN or LCSW) for USA-remote work in approved states. The role focuses on reviewing clinical cases, identifying quality, safety, and utilization concerns, and supporting improvement across a complex healthcare network.

You will collaborate with Medical Directors, participate in quality committees, and ensure regulatory compliance.

Qualifications

• Active, unrestricted RN or LCSW license.
• Minimum 3+ years of clinical experience (medical/surgical and/or behavioral health).
• Ability to obtain and maintain a DoD background clearance.
• Strong analytical and critical thinking skills.

Responsibilities

• Review medical records to identify potential quality, safety, and utilization concerns.
• Conduct detailed case analysis and prepare clear, well-documented summaries and recommendations.
• Support peer review processes and quality improvement initiatives.
• Analyze trends and assist in identifying patterns in care delivery and outcomes.
• Collaborate with clinical leadership, including Medical Directors, to review findings.
• Participate in quality committees and performance improvement efforts.
• Ensure compliance with regulatory requirements and program standards.
• Coordinate with cross-functional teams such as case management, care coordination, and program integrity.

Skills

Clinical judgment

Analytical thinking

Regulatory/compliance awareness

Communication skills

Education

Bachelor's degree in Nursing or healthcare field

Tools

Microsoft Word

Excel

EMR systems

Job description

TEEMA is partnering with a leading organization to recruit a Clinical Quality Reviewer (RN or LCSW) for USA-remote work in approved states. The role focuses on reviewing clinical cases, identifying quality, safety, and utilization concerns, and supporting improvement across a complex healthcare network.

You will collaborate with Medical Directors, participate in quality committees, and ensure regulatory compliance.