What are the responsibilities and job description for the Clinical Quality Reviewer - REMOTE - LCSW OR RN - US Citizen Required position at Lynn Rodens?
Compensation: $85,000 – $92,000
Hourly Equivalent: ~$41–$44/hr
Location: Remote
Schedule: Must work AZ hours (typically 1st shift)
CLIENT NOTES / EXPECTATIONS
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)
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
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:
- RN
- Minimum 3 years clinical experience (med/surg and/or behavioral health)
- Strong clinical documentation writing ability
- U.S. Citizenship required
- Must be eligible for DoD background clearance
- 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
- Review medical records for quality, safety, and utilization issues
- Identify Potential Quality Issues (PQIs)
- Write detailed case summaries recommendations
- Support peer review quality improvement initiatives
- Collaborate with Medical Directors
- Analyze trends and recommend improvements
- Ensure compliance with regulatory and program standards
- Clinical reviewer / utilization review nurse
- Experience with health plans or large healthcare systems
- Experience in Med-Surg in a hospital environment
- Strong analytical writing skills
Salary : $41 - $44