Clinical Quality Reviewer - REMOTE - RN - US Citizen Required

$85k - $92k

TEEMA

Phoenix, AZ

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:

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

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Vacancy posted 5 days ago

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