Clinical Quality Nurse Reviewer
Company: VirtualVocations
Location: Hartford
Posted on: November 14, 2024
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Job Description:
A company is looking for a Clinical Quality Nurse Reviewer, Sr.
Specialist (RN Remote in US).
Key Responsibilities
Perform quality assurance checks on complex clinical claims
Analyze claim data and synthesize medical records using approved
clinical guidelines
Identify quality trends and develop remediation activities,
including educational materials and training sessions
Required Qualifications, Training, and Education
Active, unrestricted RN licensure in the United States and state of
primary home residency
Associate degree required; bachelor's degree preferred
5+ years of clinical experience in an acute setting
3+ years of medical record review/auditing experience preferred
Expert level experience applying MCG and/or InterQual criteria
Keywords: VirtualVocations, Hartford , Clinical Quality Nurse Reviewer, Healthcare , Hartford, Connecticut
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