Remote Clinical QA Nurse — Quality & Compliance

TEKsystems; Orlando (FL); Remote; USD 36,000 - 39,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) retirement plan

PTO / leave

Job summary

TEKsystems seeks a Clinical Quality Assurance Nurse to ensure high-quality case reports and regulatory compliance. The role supports the Quality Assurance Department and handles QA questions while upholding client specifications and federal/state mandates.

The position requires an RN or LPN/LVN and strong medical knowledge, with pay ranging per role and location. Fully remote work is available with Contract-to-Hire in Orlando, FL.

Qualifications

• Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
• Must be a qualified typist with a minimum of 40 W.P.M
• Must have a full understanding of HIPAA regulations and compliance.
• Must be able to operate a general computer, fax, copier, scanner, and telephone.
• Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
• Must demonstrate exceptional communication skills.
• Ability to follow instructions and respond to upper managements directions accurately.
• Must demonstrate accuracy and thoroughness. Look for ways to improve and promote quality and monitors own work to ensure quality is met.
• Must be able to work independently, prioritize work activities and use time efficiently.
• Must be able to maintain confidentiality.
• Must be able to demonstrate and promote a positive team -oriented environment.
• Must be able to stay focused and concentrate under normal or heavy distractions.
• Must be able to work well under pressure and or stressful conditions.
• Must possess the ability to manage change, delays, or unexpected events appropriately.

Responsibilities

• Perform quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
• Ensure clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
• Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
• Ensure that all references cited are current and obtained from reputable medical journals and/or publications.
• Ensure the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
• Ensure the appropriate board specialty has reviewed the case in compliance with client specifications or state mandates and is documented accurately on the case report.
• Verify that the peer reviewer has attested to only the facts and that no evidence of reviewer conflict of interest exists.
• Ensure the provider credentials and signature are adhered to the final report.
• Identify any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.
• Assist in resolution of client complaints and quality assurance issues as needed.
• Ensure all federal ERISA and state mandates are adhered to at all times.
• Provide insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.
• Promote effective and efficient utilization of company resources.
• Participate in various educational and or training activities as required.
• Perform other duties as assigned.

Skills

Medical terminology

HIPAA compliance

Typing 40 WPM

Microsoft Word

Outlook

Excel

Communication skills

Independent work

Confidentiality

Time management

Attention to detail

Team player

Education

Registered Nurse license

Tools

Microsoft Word

Outlook

Excel

Internet

Job description

TEKsystems seeks a Clinical Quality Assurance Nurse to ensure high-quality case reports and regulatory compliance. The role supports the Quality Assurance Department and handles QA questions while upholding client specifications and federal/state mandates.

The position requires an RN or LPN/LVN and strong medical knowledge, with pay ranging per role and location. Fully remote work is available with Contract-to-Hire in Orlando, FL.