Clinical Quality Assurance Supervisor

🔥 0 minutes ago

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Dane Street

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

📋 Compliance

🏛️ Government

Healthcare Insurance • Compliance • Government

Dane Street is a national leader in Independent Medical Exams and Reviews, providing objective, compliant, and timely Independent Medical Examinations, Peer Reviews, and other medical reports. With a large network of over 16,000 physicians, the company offers its services across 25,000 locations and 100 specialties, including Workers' Compensation, Auto, Liability, and Disability claims. Dane Street supports Insurance Carriers, Third Party Administrators, Managed Care Organizations, and Federal/State entities with expert medical analyses, helping them make accurate determinations. The company is recognized for its quality, fast turnaround times, and efficient processes, earning accolades like the NCQA Accreditation in Utilization Management and the Great Place to Work certification.

📋 Description

• The Clinical QA Supervisor is responsible for the oversight of the review of Physician reports and accompanying medical records to ensure that the report is complete, accurate, and consistent with medical evidence. • Oversight of QA staff • - Ensure appropriate QA staff are assigned to each file to designate file handling responsibilities amongst the team. • - Supervise the assigned staff and manage the File Review Board to ensure a timely and accurate process of each file. • - Provide details of board reviews to managers to ensure efficiency and productivity of staff. • - Assist in identifying & correcting staff performance including promotions, discipline, coaching and termination of staff. • - Assist in hiring qualified candidates for QA open positions. • Ensure that all QA staff adhere to and meet their specific job duties including but not limited to: • - Following up with Physicians for outstanding reports • - Reviewing received reports for accuracy • - Delivering completed reports back to all applicable parties • - Following all client-specific instructions • - Actively participate in issue resolution by working with the required QA, physicians, account managers, and/or other related parties. • - Ensure referrals meet the client-directed Turn Around Time (TAT). • - Act as the liaison between the reviewer, team member and client regarding the process or status of the file. • - Other duties & special projects, as assigned and based on business needs.

🎯 Requirements

• EDUCATION/CREDENTIALS: • An Associate’s Degree or Bachelor’s Degree is preferred. • **RN licensure required **** • JOB RELEVANT EXPERIENCE: • Medical peer review or healthcare industry knowledge required. • Business experience in a healthcare and/or insurance setting is preferred. • JOB RELATED SKILLS/COMPETENCIES: • Present exceptional communication skills with a clear understanding of company business lines. The ability to apply critical thinking, manage time efficiently and meet specific deadlines. Computer literacy and typing skills are essential.

🏖️ Benefits

• Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.