Clinical Quality Assurance Coordinator (32489)

About the role

MES is seeking a self-driven, high-performing RN or LPN to join their dynamic team as a Clinical Quality Assurance Coordinator. This role ensures Peer Review case reports meet the highest standards of quality and integrity.

Responsibilities

• Quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
• Ensure clear, concise, evidence-based rationales are provided in support of all recommendations and/or determinations.
• Ensure all client instructions and specifications are followed and all questions are addressed.
• Ensure reports are supported by clinical citations and references when applicable and verify these references are current and from reputable sources.
• Ensure reports meet company standards in terms of content, format, and professional appearance.
• Ensure the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately.
• Identify inconsistencies within the report and contact the Peer Reviewer for clarification, modification, or correction as needed.
• Aid in resolving customer complaints and quality assurance issues as needed.
• Ensure adherence to federal ERISA and/or state mandates at all times.
• Provide insight and direction to management on consultant quality, availability, and compliance with all company policies and procedures and client specifications.
• Promote effective and efficient utilization of company resources.
• Participate in various educational and/or training activities as required.
• Perform other duties as assigned.

Requirements

• Active RN/LPN 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.
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; ability to compute rates and percentages.
• Qualified typist with a minimum of 40 W.P.M.
• Knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
• Excellent communication skills by conveying necessary information accurately, listening effectively, and asking questions where clarification is needed.
• Ability to work independently, prioritize work activities, and use time efficiently.
• Exceptional attention to detail and ability to maintain confidentiality.

Qualifications

• Active RN/LPN 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.
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers and decimals; ability to compute rates and percentages.
• Qualified typist with a minimum of 40 W.P.M.
• Knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
• Excellent communication skills by conveying necessary information accurately, listening effectively, and asking questions where clarification is needed.
• Ability to work independently, prioritize work activities, and use time efficiently.
• Exceptional attention to detail and ability to maintain confidentiality.

Skills

• Strong attention to detail.
• Exceptional communication skills.
• Ability to work independently and prioritize tasks.
• Confidentiality and integrity.

Benefits

• Medical, vision, and dental coverage.
• Paid time off.
• 401(k) plan.

Pay

Competitive salary based on experience and qualifications.

Schedule

12:00pm - 8:30pm EST, Monday through Friday; occasional weekends and holidays.