• Clinical Quality Assurance Nurse

    Requisition ID
    2000-26
    # of Openings
    1
    Category
    Operations
    Location
    US-MA-Norwood
  • Overview

    Looking for a role that doesn’t require working nights, holidays or weekends? Looking to stay in the nursing world and utilize your clinical background? Exam Works offers nurses an ideal work/life balance, allowing you to work from home three days per week once fully trained!

     

    We are seeking passionate and skilled RN’s to serve as a Clinical Quality Assurance Nurse (internally known as Clinical Quality Assurance Coordinator), reviewing cases and ensuring all necessary information has been provided and is accurate before sending back to requestor.

     

    Responsibilities

    Responsibilities:

    • Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
    • Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations
    • Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.
    • Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.
    • Ensures the provider credentials and signature are adhered to the final report.
    • Identifies any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.

    Qualifications

    ADDITIONAL DUTIES AND RESPONSIBILITES

    • Ability to work a 7:30am – 4:30pm schedule two days of the week and 12:00pm – 8:00pm schedule three days of the week. This role allows you to work from home three days per week once fully trained.

     

    EDUCATION AND/OR EXPERIENCE 

    • Must be a graduate of an accredited nursing program or related medical experience; bachelor's degree preferred.
    • A minimum of two years clinical or related field experience; or equivalent combination of education and experience.
    • Must e comfortable wiht computer skills; knowledge of microsfot office and outlook.

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