Clinical Quality Assurance Coordinator (31941)

Ready for a Rewarding Career that Fits Your Lifestyle? Imagine a job where you can keep your clinical skills sharp, tackle exciting challenges, and work from the comfort of your own home. Sounds like the perfect mix, right? MES is looking for a self‑driven, high‑performing Registered Nurse (RN) or Licensed Vocational Nurse (LVN) to join our dynamic team as a Clinical Quality Assurance Coordinator. In this role, you’ll ensure our Peer Review case reports are of exceptional quality while staying fully aligned with client agreements, regulatory standards, and state and federal mandates. The position is 100% remote with a schedule of Monday through Friday 11:30 a.m. – 8:00 p.m. EST. Responsibilities Perform quality assurance review of peer review reports, correspondences, addendums, or supplemental reviews. Ensure clear, concise, evidence‑based rationales support all recommendations and determinations. Confirm all client instructions, specifications, and questions are fully addressed. Verify that each review is supported by clinical citations and references, and that those references are current and obtained from reputable medical journals and/or publications. Ensure that the content, format, and professional appearance of the reports meet the highest quality standards and company policies. Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report. Verify the peer reviewer has attested only to the facts and that no conflict of interest exists. Ensure provider credentials and signatures are included in the final report. Identify inconsistencies within the report and contact the Peer Reviewer for clarification or correction as needed. Assist in resolution of customer complaints and quality assurance issues. Adhere to all federal ERISA and/or state mandates at all times. Provide insight to management on consultant quality, availability, and compliance with company policies and client specifications. Promote effective and efficient utilization of company resources. Participate in various educational and training activities as required. Perform other duties as assigned. Qualifications Active RN/LVN nursing license required. Graduate of an accredited nursing program or related medical experience; bachelor’s degree preferred. Minimum of two years clinical or related field experience, or equivalent combination of education and experience. Strong knowledge of medical terminology, anatomy and physiology, medications, and laboratory values. Proficient in arithmetic calculations. Qualified typist with a minimum of 40 W.P.M. Ability to operate a general computer, fax, copier, scanner, and telephone. Knowledgeable of multiple software programs, including Microsoft Word, Outlook, Excel, and the Internet. Excellent English skills: usage, grammar, punctuation, and style. Ability to follow instructions and respond to upper management’s directions accurately. Demonstrates accuracy, thoroughness, and a commitment to continuous quality improvement. Exceptional communication skills, with the ability to convey information accurately, listen effectively, and ask clarifying questions. Ability to work independently, prioritize tasks, and use time efficiently. Maintains confidentiality of sensitive information. MES offers a fast‑paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401(k). Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws. Equal Opportunity Employer - Minorities / Females / Disabled / Veterans #J-18808-Ljbffr MCMC Services, LLC