Group Health Quality Analyst 1 – Nights

🔥 13 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 25%

infoinfo
Apply Now
Find Similar Remote Jobs

📊 Check your resume score for this job

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

Logo of Dane Street

Dane Street

51 - 200 employees

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

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

• Communicate with customers, reviewers, physicians, office staff, and management to ensure completed reports are delivered by customer-requested due dates • Ensure reviewer reports are timely, complete, clinically accurate, and compliant with customer requirements, company best practices, and jurisdictional standards • Provide regular report status updates to clients • Clarify ambiguous report questions with clients • Distribute final reports according to client-specific requirements • Coordinate clarification and addendum requests from clients • Participate in client phone calls or meetings regarding questioned reports • Follow up with clients for missing referral information • Work directly with physicians to answer client questions and support clinical rationale • Follow up with physicians or office staff to ensure on-time report delivery • Provide verbal or written feedback and clarification requests to physicians • Obtain physician approval and signature for final reports • Review physician reports for data accuracy, spelling, grammar, and punctuation • Ensure state reporting requirements, report formatting, client requirements, and special handling instructions are met • Provide oversight to team members as needed • Improve processes to enhance turnaround time, peer-to-peer success rates, and client satisfaction • Give final approval for cases released to clients • Liaise with and coordinate quality issue reports and new reviewer reports with the VP of Clinical Operations • Perform other duties and special projects as assigned

🎯 Requirements

• Associate’s or Bachelor’s Degree preferred • LPN or RN license required • Business experience in a healthcare and/or insurance setting preferred • Exceptional communication skills • Clear understanding of company business lines • Ability to apply critical thinking • Ability to manage time efficiently and meet specific deadlines • Computer literacy and typing skills • Ability to supply and support personal internet services • Uninterrupted internet connection required for work-from-home position • Ability to perform required lifting, bending, traveling, prolonged sitting, and computer work

🏖️ Benefits

• Medical, dental, and vision coverage for employees and families • Voluntary life insurance for employees, spouses, and children • Voluntary hospital indemnity, critical illness, accident indemnity, and pet insurance plans • Basic life insurance at no cost • Short-term disability coverage at no cost • Long-term disability coverage at no cost • Paid time off • 401(k) plan with company match • Apple equipment for remote workspace • Media stipend for remote workspace • Remote work arrangement

Apply Now

Similar Jobs

🔥 14 hours ago

Concept Plus, LLC

51 - 200

💼 Consulting

🏥 Healthcare

📦 Logistics

Cybersecurity Analyst securing Concept Plus federal software modernization initiatives through RMF/ATO lifecycle management. Performing cloud vulnerability remediation and DoD compliance within Agile/DevSecOps teams.

🔥 16 hours ago

McKesson

10,000+ employees

💼 Consulting

📦 Logistics

🏥 Healthcare

Payment reimbursement analyst processing vendor invoices and reimbursement workflows for SCRI’s community-based oncology clinical research programs. Reconciling claims, contracts, budgets, and coverage analyses.

🔥 17 hours ago

RightMove Health

11 - 50

🏥 Healthcare

👥 B2C

🧘 Wellness

Senior Healthcare Economics Analyst measuring outcomes, savings, and total cost of care for RightMove’s value-based MSK platform. Supporting employer and health-plan decisions with claims, EHR, and network analytics.

🔥 17 hours ago

Wing

51 - 200

🍽️ Food & Beverage

🏥 Healthcare

✈️ Travel

Business Systems Analyst configuring SAP MM, SCM, and S2P systems for Wing’s drone delivery logistics. Integrating supply-chain platforms and supporting SAP implementations.

🔥 18 hours ago

Allstate

10,000+ employees

💼 Consulting

📦 Logistics

🛡️ Insurance

Senior Coverage Analyst evaluating complex insurance claims and coverage disputes for Allstate. Negotiating settlements, guiding litigation strategy, and collaborating with counsel.