Remote Clinical QA Analyst (RN-BSN) - Quality & Compliance

Complexcare Solutions, Inc.; United States; Remote; USD 44,000 - 52,000; Full time

Job summary

ComplexCare Solutions, Inc. is seeking a Clinical Quality Assurance Analyst (RN-BSN required) for a temporary remote role lasting up to one year. The position focuses on auditing and training to support clinical data standards across the enterprise.

The ideal candidate will have a BSN and at least five years of nursing experience, plus experience with quality improvement initiatives in healthcare plans. Compensation is market-driven and remote.

Qualifications

• Minimum five (5) years' clinical nursing background.
• Minimum four (4) years' experience in healthcare plan quality improvement initiatives preferred; minimum three (3) years' experience with public programs (e.g., Medicare, Medicaid) is highly preferred.
• Excellent analytical skills and the ability to understand CCS products and processes.

Responsibilities

• Demonstrate and maintain expert knowledge of CCS clinical chart review and auditing from a clinical data extract standpoint.
• Assist with development and implementation of companywide quality improvement efforts.
• Maintain quality control and monitoring of quality reporting mechanisms and tools.
• Perform analyses of reviews and consolidate findings for senior leadership reporting.
• Ensure compliance with contractual, local, state and national quality standards.
• Support clinical product strategy through research, comparisons, and market analysis.
• Facilitate clinical project implementations to meet scope, time, and budget requirements.
• Contribute to CCS training processes for review personnel.

Skills

Analytical skills

Organizational skills

MS Office

Clinical skills

Education

Bachelor's degree in Nursing (BSN)

Job description

ComplexCare Solutions, Inc. is seeking a Clinical Quality Assurance Analyst (RN-BSN required) for a temporary remote role lasting up to one year. The position focuses on auditing and training to support clinical data standards across the enterprise.

The ideal candidate will have a BSN and at least five years of nursing experience, plus experience with quality improvement initiatives in healthcare plans. Compensation is market-driven and remote.